New-onset heart failure in infants

This study aimed to report the findings of cardiac magnetic resonance imaging (CMR) with quantitative mappings in infants presenting with new-onset heart failure, as well as to assess the capabilities of endomyocardial biopsy (EMB) and CMR in detecting inflammatory cardiomyopathies and determining t...

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Autores: Esmel Vilomara, Roger|||0000-0003-4449-3217, Riaza Martin, Lucía|||0000-0001-8742-8453, Dolader, Paola|||0000-0003-3497-4201, Sabaté-Rotés, Anna|||0000-0002-3127-7673, Rosés-Noguer, Ferran|||0000-0002-5955-7490, Gran, Ferran|||0000-0001-9076-241X
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:310765
Acceso en línea:https://ddd.uab.cat/record/310765
https://dx.doi.org/urn:doi:10.1007/s00431-023-05286-5
Access Level:acceso abierto
Palabra clave:Cardiac magnetic resonance
Dilated cardiomyopathy
Endomyocardial biopsy
Heart failure
Inflammatory cardiomyopathy
Myocarditis
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spelling New-onset heart failure in infantswhen the aetiological diagnosis becomes a challengeEsmel Vilomara, Roger|||0000-0003-4449-3217Riaza Martin, Lucía|||0000-0001-8742-8453Dolader, Paola|||0000-0003-3497-4201Sabaté-Rotés, Anna|||0000-0002-3127-7673Rosés-Noguer, Ferran|||0000-0002-5955-7490Gran, Ferran|||0000-0001-9076-241XCardiac magnetic resonanceDilated cardiomyopathyEndomyocardial biopsyHeart failureInflammatory cardiomyopathyMyocarditisThis study aimed to report the findings of cardiac magnetic resonance imaging (CMR) with quantitative mappings in infants presenting with new-onset heart failure, as well as to assess the capabilities of endomyocardial biopsy (EMB) and CMR in detecting inflammatory cardiomyopathies and determining their etiology. In a prospective analysis of infants who underwent CMR with tissue mappings, EMB, and genetic testing, the sample was categorized into two groups: those with inflammatory cardiomyopathy and negative genetics (indicative of possible myocarditis) and those with positive genetics (indicative of possible dilated cardiomyopathy). All patients exhibited similar clinical presentations, echocardiographic dysfunction, and elevated troponins and NT-proBNP levels. Additionally, they all met the diagnostic criteria for inflammatory cardiomyopathy based on EMB findings (≥14 mononuclear cells, ≥7 T-lymphocytes/mm2). EMB results unveiled significant differences in the presence of inflammation and edema between the two groups, with higher troponin levels correlating with increased inflammation. Notably, when focusing on CMR, neither the classic criteria nor the 2018 Lake Louise criteria (LLC) could effectively differentiate between the two groups. Only late gadolinium enhancement (LGE) appeared to be associated with myocarditis in this cohort, while other LLC and tissue mappings did not exhibit a similar correlation. Importantly, there was no observed correlation between the inflammation detected through EMB and CMR. Conclusions: The onset of heart dysfunction in infants can result from either inherited factors or viral infections, both of which may involve inflammation. However, the precise role of EMB and CMR in determining the etiology of such cases remains poorly defined. While CMR demonstrates high sensitivity in detecting inflammation, our experience suggests that it may not effectively differentiate between these two groups. A comprehensive diagnostic approach is essential when addressing this challenge, which includes considering EMB (with attention to the number of T-lymphocytes and the presence of oedema), specific CMR criteria, notably LGE and tissue mappings, as well as the identification of viral agents in cardiac tissue and troponin levels. Additionally, genetic tests should be conducted when evaluating these patients. 22024-01-0120242024-01-01Articlehttp://purl.org/coar/resource_type/c_6501AMhttp://purl.org/coar/version/c_ab4af688f83e57aainfo:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/310765https://dx.doi.org/urn:doi:10.1007/s00431-023-05286-5reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest material està protegit per drets d'autor i/o drets afins. Podeu utilitzar aquest material en funció del que permet la legislació de drets d'autor i drets afins d'aplicació al vostre cas. Per a d'altres usos heu d'obtenir permís del(s) titular(s) de drets.https://rightsstatements.org/vocab/InC/1.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3107652026-06-06T12:50:31Z
dc.title.none.fl_str_mv New-onset heart failure in infants
when the aetiological diagnosis becomes a challenge
title New-onset heart failure in infants
spellingShingle New-onset heart failure in infants
Esmel Vilomara, Roger|||0000-0003-4449-3217
Cardiac magnetic resonance
Dilated cardiomyopathy
Endomyocardial biopsy
Heart failure
Inflammatory cardiomyopathy
Myocarditis
title_short New-onset heart failure in infants
title_full New-onset heart failure in infants
title_fullStr New-onset heart failure in infants
title_full_unstemmed New-onset heart failure in infants
title_sort New-onset heart failure in infants
dc.creator.none.fl_str_mv Esmel Vilomara, Roger|||0000-0003-4449-3217
Riaza Martin, Lucía|||0000-0001-8742-8453
Dolader, Paola|||0000-0003-3497-4201
Sabaté-Rotés, Anna|||0000-0002-3127-7673
Rosés-Noguer, Ferran|||0000-0002-5955-7490
Gran, Ferran|||0000-0001-9076-241X
author Esmel Vilomara, Roger|||0000-0003-4449-3217
author_facet Esmel Vilomara, Roger|||0000-0003-4449-3217
Riaza Martin, Lucía|||0000-0001-8742-8453
Dolader, Paola|||0000-0003-3497-4201
Sabaté-Rotés, Anna|||0000-0002-3127-7673
Rosés-Noguer, Ferran|||0000-0002-5955-7490
Gran, Ferran|||0000-0001-9076-241X
author_role author
author2 Riaza Martin, Lucía|||0000-0001-8742-8453
Dolader, Paola|||0000-0003-3497-4201
Sabaté-Rotés, Anna|||0000-0002-3127-7673
Rosés-Noguer, Ferran|||0000-0002-5955-7490
Gran, Ferran|||0000-0001-9076-241X
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Cardiac magnetic resonance
Dilated cardiomyopathy
Endomyocardial biopsy
Heart failure
Inflammatory cardiomyopathy
Myocarditis
topic Cardiac magnetic resonance
Dilated cardiomyopathy
Endomyocardial biopsy
Heart failure
Inflammatory cardiomyopathy
Myocarditis
description This study aimed to report the findings of cardiac magnetic resonance imaging (CMR) with quantitative mappings in infants presenting with new-onset heart failure, as well as to assess the capabilities of endomyocardial biopsy (EMB) and CMR in detecting inflammatory cardiomyopathies and determining their etiology. In a prospective analysis of infants who underwent CMR with tissue mappings, EMB, and genetic testing, the sample was categorized into two groups: those with inflammatory cardiomyopathy and negative genetics (indicative of possible myocarditis) and those with positive genetics (indicative of possible dilated cardiomyopathy). All patients exhibited similar clinical presentations, echocardiographic dysfunction, and elevated troponins and NT-proBNP levels. Additionally, they all met the diagnostic criteria for inflammatory cardiomyopathy based on EMB findings (≥14 mononuclear cells, ≥7 T-lymphocytes/mm2). EMB results unveiled significant differences in the presence of inflammation and edema between the two groups, with higher troponin levels correlating with increased inflammation. Notably, when focusing on CMR, neither the classic criteria nor the 2018 Lake Louise criteria (LLC) could effectively differentiate between the two groups. Only late gadolinium enhancement (LGE) appeared to be associated with myocarditis in this cohort, while other LLC and tissue mappings did not exhibit a similar correlation. Importantly, there was no observed correlation between the inflammation detected through EMB and CMR. Conclusions: The onset of heart dysfunction in infants can result from either inherited factors or viral infections, both of which may involve inflammation. However, the precise role of EMB and CMR in determining the etiology of such cases remains poorly defined. While CMR demonstrates high sensitivity in detecting inflammation, our experience suggests that it may not effectively differentiate between these two groups. A comprehensive diagnostic approach is essential when addressing this challenge, which includes considering EMB (with attention to the number of T-lymphocytes and the presence of oedema), specific CMR criteria, notably LGE and tissue mappings, as well as the identification of viral agents in cardiac tissue and troponin levels. Additionally, genetic tests should be conducted when evaluating these patients.
publishDate 2024
dc.date.none.fl_str_mv 2
2024-01-01
2024
2024-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
AM
http://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/310765
https://dx.doi.org/urn:doi:10.1007/s00431-023-05286-5
url https://ddd.uab.cat/record/310765
https://dx.doi.org/urn:doi:10.1007/s00431-023-05286-5
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://rightsstatements.org/vocab/InC/1.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://rightsstatements.org/vocab/InC/1.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
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repository.mail.fl_str_mv
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