Cardiac Involvement In Idiopathic Inflammatory Myopathy

Objective:The aim of the study is to observe the cardiac involvement in idiopathic inflammatory myopathies and to investigate cardiac involvement in patients with idiopathic inflammatory myopathies with cardiac magnetic resonance tomography (CMR).Methods:Choose series patients with polymyositis, dermatomyositis, necrotizing autoimmune myositis or nonspecific myositis in our department between 2013.9-2015.12 underwent electrocardiogram?echocardiogram and CMR. Compared the above results to healthy controls. CMR including functional imaging and late gadolinium enhancement (LGE) imaging. Analyze the results of CMR to learn the characteristics of cardiac damage in patients with IIM.Results:we select 56 patients with IIM and 38 healthy controls. The cardiac involvemen rate of IIM is higher than the healthy control. Abnormal rate of the electrocardiogram for the IIM is 16.1%, higher than that of the healthy control which the rate is 7.9%. Abnormal rate of the echocardiogram for the IIM is 12.5%, higher than that of the healthy control which the rate is 5.3%. Abnormal rate of the CMR for the IIM is 35.7%,abnormal rate of the LGE for the IIM is 30.4%, both of them were statistically significant higher compared with healthy control group,P= 0.015? 0.0029; Patients with reduced LVF more often presented with late myocardial enhancement,P=0.0065. These patients had significantly lower left ventricular ejection fractions and Ventricular contraction ratio compared to patients without LGE P=0.0002?P=0.0023. and the end systolic diameter of the left ventricle is higer, P=0.0039. Cardiac damage of LGE of idiopathic inflammatory myopathy are more present in anterior basal spacing section, then in upper middle interval segment and in the anterior middle lateral section.Conclusion:The incidence of cardiac involvement in idiopathic inflammatory myopathy is high. For the CMR, the positive rate of the heart involvement is higher than other traditional tests include electrocardiogram and echocardiogram,seems to offer a measurable and quantifiable diagnostic tool for cardiac involvement of idiopathic inflammatory myopathies.Objective To analyze T2 maps and iterative decomposition of water and fat with echo asymmetric and least-squares estimation (IDEAL) of thigh muscles in idiopathic inflammatory myopathy,and try to find the correction between T2 maps-IDEAL with cardiac involvement in idiopathic inflammatory myopathy.Try to get the correction between cardiac involvement and the muscle damage in idiopathic inflammatory myopathy.Methods:Choose a case series of patients with polymyositis, dermatomyositis, necrotizing autoimmune myositis or nonspecific myositis in our department between2013.9-2015.12 underwent muscle MRI.Compared the above results to age? sex matched healthy controls. CMR including functional imaging and late gadolinium enhancement (LGE) imaging. Analyze the results of CMR to learn the characteristics of cardiac damage in patients with IIMs.Use T2mapping% IDEAL to quantitatively measuring values.Measured muscles include:intermediate muscle, vastus lateralis muscle, shares the inside of the muscle and adductor muscles, tendons, and membrane and kowtow the biceps femoris muscle.Try to get the correlation with MMT scores^ HAQ scores?ADL scores?duration of the disease.Compare the quantitative value of t2mapping?fat in the patients with cardiac damage and without cardiac damage in patients with IIMs.Results:The quantitative value of t2mapping is higher compared with the control group, and have statistical differences (P=0.0014). The quantitative value of fat is higher compared with the control group, and have statistical differences (P=0.036) the quantitative value of t2mapping have correlation with the MMT scores?HAQ scores, ADL scores,but have no correlation with duration of the disease.The quantitative value of fat have no correlation with the MMT scores? HAQ scores, ADL scores, duration of the disease; In the patients with cardiac damage, quantitative value of T2mapping is higher than the patients without cardiac damage, and statistically difference was found (P=0.027). In the patients with cardiac damage, quantitative value of fat is higher than the patients without cardiac damage, but no statistically.difference was found (P= 0.17).Conclusions:Relative to the IDEAL sequence of fat quantitative, the MRI T2 mapping sequence can be used as a quantitative measure of muscle inflammation and it has good correlations with disease activity and the muscle damage.Objective:The aim of the study is to observe the risk factors of cardiac involvement in idiopathic inflammatory myopathy.Methods:The 56 patients in our department between2013.9-2015.12 were retrospective analysed. The factor of the cardiac involvement in idiopathic inflammatory myopathy were age?sex?course of the disease?creatine kinase (CK)?Creatine Kinase MB (CK-MB)?AS?ALT?troponin I?antinuclear antibody?erythrocyte sedimentation rate?c-reactive protein (CRP)?brain natriuretic peptide(BNP)?the degree of cells infiltrating?the degree of cell necrosis?pulmonary interstitial lesions were screened through ?2 test and T test before multivariate logistic regression analysis was performed.Results:The sex?course of the disease?troponin I?antinuclear antibody? erythrocyte sedimentation rate?brain natriuretic peptide(BNP) have statistically significant through ?2 test and T test.Multivariate logistic regression show that sex (female)?erythrocyte sedimentation rate (P=0.012)?antinuclear antibody (P=0.016) are the risk factors of cardiac involvement in idiopathic inflammatory myopathy.Conclusion:Female?erythrocyte sedimentation rate?antinuclear antibody are the risk factors of cardiac involvement in idiopathic inflammatory myopathy. We should try to early diagnosis and intervention treatment to the IIM patients with above risks factors, in order to reduce the mortality of autoimmune myopathy, reduce the risk of death.