scholarly journals Is it cardiac involvement mimicking acute myocardial infarction in idiopathic inflammatory myopathy?

2017 ◽  
Vol 14 (1) ◽  
pp. 349-354 ◽  
Author(s):  
Yizhi Xiao ◽  
Hui Luo ◽  
Shiqing Liu ◽  
Liping Duan ◽  
Yunhui You ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Involvement ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy

scholarly journals Saw-scaled viper envenoming complicated with acute myocardial infarction

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110077
Author(s):  
Selladurai Pirasath ◽  
Dilani Gajan ◽  
Mahesan Guruparan ◽  
Arumugam Murugananthan ◽  
Ariaranee Gnanathasan
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Sri Lanka ◽  
Renal Impairment ◽  
Cardiac Involvement ◽  
Cardiac Toxicity ◽  
National Guidelines ◽  
Venomous Snake ◽  
Systemic Manifestations ◽  
Echis Carinatus

The saw-scaled viper ( Echis carinatus) is considered to be a venomous snake which is especially seen in Northern Sri Lanka. Systemic manifestations are rare and reported complications include coagulopathy and renal impairment. The cardiac toxicity following snakebites is rare and cardiac involvement following the saw-scaled viper bites is extremely rare. Here, we describe a patient with acute myocardial infarction following systemic envenoming by saw-scaled viper in Northern Sri Lanka, which was successfully managed per ward protocol following national guidelines.

scholarly journals ECG Changes Through Immunosuppressive Therapy Indicate Cardiac Abnormality in Anti-MDA5 Antibody-Positive Clinically Amyopathic Dermatomyositis

2022 ◽  
Vol 12 ◽  
Author(s):  
Takashi Matsuo ◽  
Tsuneo Sasai ◽  
Ran Nakashima ◽  
Yoshihiro Kuwabara ◽  
Eri Toda Kato ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Cardiac Involvement ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Active Phase ◽  
Muscle Enzymes ◽  
T Wave ◽  
Group I ◽  
Remission Phase ◽  
Active Disease

Anti-melanoma differentiation-associated gene 5 (MDA5) antibody, a dermatomyositis (DM)-specific antibody, is strongly associated with interstitial lung disease (ILD). Patients with idiopathic inflammatory myopathy (IIM) who are anti-MDA5 antibody positive [anti-MDA5 (+)] often experience chest symptoms during the active disease phase. These symptoms are primarily explained by respiratory failure; nevertheless, cardiac involvement can also be symptomatic. Thus, the aim of this study was to investigate cardiac involvement in anti-MDA5 (+) DM. A total of 63 patients with IIM who underwent electrocardiography (ECG) and ultrasound cardiography (UCG) during the active disease phase from 2016 to 2021 [anti-MDA5 (+) group, n = 21; anti-MDA5-negative (-) group, n = 42] were enrolled in the study, and their clinical charts were retrospectively reviewed. The ECG and UCG findings were compared between the anti-MDA5 (+) and anti-MDA5 (-) groups. All anti-MDA5 (+) patients had DM with ILD. The anti-MDA5 (+) group showed more frequent skin ulcerations and lower levels of leukocytes, muscle enzymes, and electrolytes (Na, K, Cl, and Ca) than the anti-MDA5 (-) group. According to the ECG findings obtained during the active disease phase, the T wave amplitudes were significantly lower for the anti-MDA5 (+) group than for the anti-MDA5 (-) group (I, II, and V4–6 lead; p < 0.01; aVF and V3, p < 0.05). However, the lower amplitudes were restored during the remission phase. Except for the E wave, A wave and Sep e’, the UCG results showed no significant differences between the groups. Four patients with anti-MDA5 (+) DM had many leads with lower T wave and cardiac abnormalities (heart failure, diastolic dysfunction, myocarditis) on and after admission. Though anti-MDA5 (+) patients clinically improved after immunosuppressive therapy, some of their ECG findings did not fully recover in remission phase. In conclusion, anti-MDA5 (+) DM appears to show cardiac involvement (electrical activity and function) during the active phase. Further studies are necessary to clarify the actual cardiac condition and mechanism of these findings in patients with anti-MDA5 (+) DM.

scholarly journals Muscle Pathological Features and Extra-Muscle Involvement in Idiopathic Inflammatory Myopathies With Anti-Mitochondrial Antibody

2020 ◽  
Author(s):  
Lu Zhang ◽  
Hanbo Yang ◽  
Jieping Lei ◽  
Qinglin Peng ◽  
Hongxia Yang ◽  
...  
Keyword(s):  
Protective Factor ◽  
Cardiac Involvement ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Primary Biliary Cholangitis ◽  
Pathological Features ◽  
Muscle Involvement ◽  
Disease Remission ◽  
Heart Abnormalities ◽  
Mitochondrial Antibody

Abstract BackgroudAnti-mitochondrial antibodies (AMAs) can be detected in some idiopathic inflammatory myopathy (IIM) patients. We aimed to investigate the clinical features of IIM patients with AMAs.Methods We retrospectively analysed consecutive 1,167 patients with IIM for AMAs-associated myositis and compared them to age- and sex-matched AMA-negative patients. ResultsTwenty-nine patients (2.5%) were identified with AMAs-positive myositis; eight of them had primary biliary cholangitis (PBC). There were no significant differences in skin rash, dysphagia, interstitial lung disease, and muscle strength between AMAs-positive patients and disease controls. 12/23(52.2%) cases showed immune-mediated necrotizing myopathy (IMNM)-like pathological features. Among AMAs-positive patients, 11 of 16 patients with isolated anti-AMA were classified as IMNM which was significantly higher than that of patients with coexistent anti-AMAs and myositis-specific antibodies (p=0.026). Moreover, AMAs-positive patients had a significantly higher cardiac involvement ratio (P<0.001) compared to controls. Comparsion in AMAs-positive IIM patients show the incidence of abnormal echocardiography findings was significantly higher in patients without primary biliary cholangitis (PBC) than in patients with PBC(P=0.009). Patients without heart abnormalities took significantly less time to achieve disease remission and prednisone tapering to <10 mg than patients with heart abnormalities (P<0.001 and P=0.001, respectively).ConclusionsIMNM was a major histopathological finding in IIM patients with isolated anti-AMAs antibody. AMAs was significantly associated with cardiac involvement in IIM. PBC seemed to be a protective factor for abnormal echocardiography findings in AMAs-positive patients. Patients without heart involvement took less time to achieve disease remission and prednisone tapering off.

The diagnostic value of GDF-15 for myocardial involvement in idiopathic inflammatory myopathy

Rheumatology ◽  
2020 ◽  
Author(s):  
Mengqian Qiu ◽  
Xiaoxuan Sun ◽  
Xiaoqing Qi ◽  
Xianfang Liu ◽  
Yue Zhang ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Cardiac Involvement ◽  
Inflammatory Myopathy ◽  
Area Under The Curve ◽  
Idiopathic Inflammatory Myopathy ◽  
Diagnostic Value ◽  
Control Group ◽  
Cellular Volume ◽  
Potential Biomarker ◽  
Myocardial Involvement

Abstract Background Cardiac involvement is a serious complication of idiopathic inflammatory myopathy (IIM). GDF-15 can predict the risk and the prognosis of cardiovascular disease, but its value is unclear in IIM. Objective To investigate the diagnostic value of GDF-15 for myocardial involvement in IIM. Methods A total of 77 IIM patients from May 2018 to August 2020 were included in this retrospective study. Of these, 43 patients underwent cardiac magnetic resonance (CMR) examination. There were 33 SLE patients and 16 healthy people were used as the control group. The concentration of GDF-15 of these groups was measured by ELISA. Results There were significant differences in GDF-15 levels in patients with IIM, SLE and healthy controls (H = 45.291, P&lt;0.001). GDF-15 levels were statistically significant different between IIM patients with the myocardial injury [1484.88(809.07 2835.50) pg/ml] and without myocardial injury [593.26(418.61 784.59) pg/ml, P =0.001]. After adjusted for age, renal function, the risk of myocardial injury in IIM patients increased an average of 0.3% by per increased unit of GDF-15 (odds ratio=1.003, 95% CI: 1.000, 1.007). The level of GDF-15 was positively correlated with extra-cellular volume (ECV) (rs = 0.348, P =0.028). GDF-15 ≥ 929.505 pg/ml (area under the curve=0.856, 95% CI: 0.744, 0.968) predicted myocardial injury in IIM with a sensitivity of 0.75 and specificity of 0.90. Conclusion GDF-15 could serve as a potential biomarker to predict myocardial injury in IIM patients.

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