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Cardiac magnetic resonance imaging in myocardial inflammation in autoimmune rheumatic diseases: An appraisal of the diagnostic strengths and limitations of the Lake Louise criteria.
Journal article

Cardiac magnetic resonance imaging in myocardial inflammation in autoimmune rheumatic diseases: An appraisal of the diagnostic strengths and limitations of the Lake Louise criteria.

  • Mavrogeni S Onassis Cardiac Surgery Center, Athens, Greece. Electronic address: soma13@otenet.gr.
  • Schwitter J Cardiovascular Department and CMR Center, University Hospital Lausanne, CHUV, Switzerland.
  • van Rossum A Dept Cardiology, VU University Medical Center, Amsterdam, The Netherlands.
  • Nijveldt R Dept Cardiology, VU University Medical Center, Amsterdam, The Netherlands.
  • Aletras A Laboratory of Computing and Medical Informatics, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
  • Kolovou G Onassis Cardiac Surgery Center, Athens, Greece.
  • Pohost G Department of Cardiology, University of South California, LA, USA.
  • Lima J Department of Medicine, Radiology and Epidemiology Johns Hopkins University, Baltimore, MD, USA.
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  • 2017-11-21
Published in:
  • International journal of cardiology. - 2018
Cardiovascular magnetic resonance
Connective tissue diseases
Coronary artery
Myocardial fibrosis
Myocardial inflammation
Myocardial ischemia
Systemic vasculitis
Autoimmune Diseases
Humans
Image Interpretation, Computer-Assisted
Inflammation
Magnetic Resonance Imaging, Cine
Myocarditis
Rheumatic Diseases
English Myocardial inflammation in autoimmune rheumatic diseases (ARDs) is the endpoint of various pathophysiologic processes. The Lake Louise-criteria is the most popular approach for the diagnosis of myocarditis. However, due to the diversity of myocardial inflammation in ARDs, some issues should be acknowledged. Of the three Lake Louise indices, early and late gadolinium enhancement (EGE and LGE respectively) measurements may be affected by co-existing disease processes or be present due to a fibrotic ARD like systemic sclerosis, leaving T2-ratio as the only uniformly robust measurement across ARDs. It thus becomes apparent that the Lake Louise criteria suffer from a number of limitations when ARD patients are assessed based on them. The introduction of T1/T2 mapping allowed the quantification of intramyocardial fibrosis missed by LGE and the detection of myocardial oedema respectively, both commonly found in ARDs. The Lake Louise criteria play an important role in the evaluation of AIMI in ARDs. However, the pathophysiologic background of cardiac involvement in ARDs should always be acknowledged in their evaluation. Even though the inclusion of T1/T2 mapping and ECV may better describe diffuse oedema and fibrosis, further investigation pertaining to their implementation in ARD assessment algorithms through multicenter studies is needed.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/248404
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