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

Sophie Mavrogeni, Juerg Schwitter, Albert van Rossum, Robin Nijveldt, Antony Aletras, Genovefa Kolovou, Gerald Pohost, Joao Lima

Research output: Contribution to journalArticle

Abstract

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.

LanguageEnglish (US)
Pages216-219
Number of pages4
JournalInternational Journal of Cardiology
Volume252
DOIs
StatePublished - Feb 1 2018

Fingerprint

Lakes
Rheumatic Diseases
Autoimmune Diseases
Magnetic Resonance Imaging
Inflammation
Edema
Fibrosis
Systemic Scleroderma
Myocarditis
Gadolinium
Multicenter Studies

Keywords

  • Cardiovascular magnetic resonance
  • Connective tissue diseases
  • Coronary artery
  • Myocardial fibrosis
  • Myocardial inflammation
  • Myocardial ischemia
  • Systemic vasculitis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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, Sophie; Schwitter, Juerg; van Rossum, Albert; Nijveldt, Robin; Aletras, Antony; Kolovou, Genovefa; Pohost, Gerald; Lima, Joao.

In: International Journal of Cardiology, Vol. 252, 01.02.2018, p. 216-219.

Research output: Contribution to journalArticle

Mavrogeni, Sophie ; Schwitter, Juerg ; van Rossum, Albert ; Nijveldt, Robin ; Aletras, Antony ; Kolovou, Genovefa ; Pohost, Gerald ; Lima, Joao. / Cardiac magnetic resonance imaging in myocardial inflammation in autoimmune rheumatic diseases : An appraisal of the diagnostic strengths and limitations of the Lake Louise criteria. In: International Journal of Cardiology. 2018 ; Vol. 252. pp. 216-219
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