The relationship between late gadolinium enhancement imaging and myocardial biopsy in the evaluation of chronic heart failure patients with suspected myocarditis.
OBJECTIVE
The aim of this study was to assess the relationship between late gadolinium-enhanced (LGE) cardiovascular magnetic resonance (CMR) and immunohistochemical markers of inflammation in patients with heart failure and a reduced ejection fraction (HFrEF).


METHODS
Endomyocardial biopsy and CMR were performed in 38 consecutive patients (24 males, average age 43.2 ± 6.9 years, New York Heart Association [NYHA] class II) with HFrEF and suspected myocarditis. The immunohistochemical evaluation was done by the En-Vision system using DAKO monoclonal antibodies. The presence of > 14 infiltrating cells together with myocardial damage and ≥ 2 + up-regulation of HLA class II was considered diagnostic for myocarditis. The results of LGE were compared with the immunohistochemical markers of inflammation. All patients underwent coronary angiography.


RESULTS
Twelve out of 38 (31.6%) patients met the immunohistological criteria for the diagnosis of myocarditis. Late gadolinium enhancement was present in 23 of 38 (60.5%) patients, mostly at the interventricular septum. No correlation was found between LGE and immunohistochemistry results (Kendall's tau; r = 0.21, p = 0.09).


CONCLUSIONS
Our study revealed no significant relationship between LGE cardiovascular magnetic resonance imaging and immunohistochemical markers of inflammation in patients with HFrEF.
3 Department of Cardiology in Zabrze, Medical University of Silesia, Katowice, Poland ; Silesian Centre for Heart Diseases, Zabrze, Poland.
Jolanta
J
Nowak
3 Department of Cardiology in Zabrze, Medical University of Silesia, Katowice, Poland ; Silesian Centre for Heart Diseases, Zabrze, Poland.
Jarosław
J
Wasilewski
Department of Histology in Zabrze, Medical University of Silesia, Katowice, Poland.
Edyta
E
Reichman-Warmusz
Silesian Centre for Heart Diseases, Zabrze, Poland.
Beata
B
Spinczyk
Silesian Centre for Heart Diseases, Zabrze, Poland ; Department of Radiology in Zabrze, Medical University of Silesia, Katowice, Poland.
Jan
J
Głowacki
Silesian Centre for Heart Diseases, Zabrze, Poland.
Karol
K
Miszalski-Jamka
Department of Histology in Zabrze, Medical University of Silesia, Katowice, Poland.
Oliwia
O
Segiet
3 Department of Cardiology in Zabrze, Medical University of Silesia, Katowice, Poland ; Silesian Centre for Heart Diseases, Zabrze, Poland.
Bożena
B
Szyguła-Jurkiewicz
Silesian Centre for Heart Diseases, Zabrze, Poland.
Mateusz
M
Tajstra
University of Silesia, Katowice, Poland.
Arkadiusz
A
Badziński
Silesian Centre for Heart Diseases, Zabrze, Poland ; Department of Histology in Zabrze, Medical University of Silesia, Katowice, Poland.
Romuald
R
Wojnicz
3 Department of Cardiology in Zabrze, Medical University of Silesia, Katowice, Poland ; Silesian Centre for Heart Diseases, Zabrze, Poland.
Lech
L
Poloński
cardiac magnetic resonance; chronic heart failure; immunohistochemistry; myocarditis