Cardiac magnetic resonance imaging of eosinophilic endomyocardial disease

Abstract Idiopathic hypereosinophilic syndrome (HES) is rare and frequently involves the heart with development of endomyocardial fibrosis, a characteristic restrictive cardiomyopathy. Non-invasive diagnosis is frequently challenging. Recent developments in cardiac magnetic resonance (CMR) imaging t...

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Bibliographic Details
Published inInternational journal of cardiology Vol. 126; no. 3; pp. e50 - e52
Main Authors Syed, Imran S, Martinez, Matthew W, Feng, Da-Li, Glockner, James F
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ireland Ltd 06.06.2008
Subjects
Cardiovascular
Contrast Media - pharmacology
Drug Therapy, Combination
Echocardiography, Transesophageal
Endomyocardial fibrosis
Endomyocardial Fibrosis - complications
Endomyocardial Fibrosis - diagnosis
Endomyocardial Fibrosis - drug therapy
Female
Follow-Up Studies
Gadolinium DTPA
Heart Failure - diagnosis
Heart Failure - etiology
Humans
Hypereosinophilic syndrome
Hypereosinophilic Syndrome - complications
Hypereosinophilic Syndrome - diagnosis
Hypereosinophilic Syndrome - drug therapy
Image Enhancement - methods
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Middle Aged
Risk Assessment
Sensitivity and Specificity
Magnetic resonance imaging
Endomyocardial fibrosis
Hypereosinophilic syndrome
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Summary:Abstract Idiopathic hypereosinophilic syndrome (HES) is rare and frequently involves the heart with development of endomyocardial fibrosis, a characteristic restrictive cardiomyopathy. Non-invasive diagnosis is frequently challenging. Recent developments in cardiac magnetic resonance (CMR) imaging techniques offer potential for improved detection and characterization of this entity. We describe the use of contrast-enhanced CMR to demonstrate thrombus, endomyocardial fibrosis and inflammation in eosinophilic endomyocardial disease. A three-layered appearance consisting of normal myocardium, thickened fibrotic endocardium with inflammatory exudate, and overlying thrombus was seen on cine-images. Post-contrast perfusion and delayed enhancement images confirmed the presence and location of endomyocardial fibrosis and thrombus. CMR is an important and powerful addition to current non-invasive diagnostic tools for the clinical diagnosis of eosinophilic endomyocardial disease, and may potentially obviate the need for cardiac biopsy in the future.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2007.01.019