ArticleRheumatology (Oxford, England)2024
Myocarditis in anti-synthetase syndrome: clinical features and diagnostic modalities.
Article in Rheumatology (Oxford, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 15 citations in OpenAlex.
- Use of advanced cardiovascular imaging in rheumatic immune-mediated inflammatory diseases.Rheumatology (Oxford, England) · 2026Article
- Myocarditis in idiopathic inflammatory myopathies: serologic and clinical correlates in a single-center registry.Rheumatology international · 2026Article
- Myocardial involvement in inflammatory myopathies: from subclinical disease to life-threatening myocarditis.Expert review of clinical immunology · 2026Review
- Cardiovascular events in patients with myositis: results from a French retrospective cohort.RMD open · 2025Observational
- Article
- Treatment Algorithms for Inflammatory Myopathies in Adults: from Guidelines to Clinical Practice.Current treatment options in rheumatology · 2025Article
- Hidden in Plain Sight: Antisynthetase Syndrome Masquerading As Acute Coronary Syndrome and Heart Failure.Cureus · 2024Article
- Advances in the diagnosis of myocarditis in idiopathic inflammatory myopathies: an overview of diagnostic tests.Rheumatology (Oxford, England) · 2024Review
- Effectiveness and safety of mycophenolate mofetil and rituximab combination therapy for immune idiopathic myopathies.Arthritis research & therapy · 2024Article
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMyocarditis is an overlooked manifestation of anti-synthetase syndrome (ASS). Our study describes the clinical and instrumental features of ASS myocarditis and evaluates the performance of cardiac MRI (CMRI) with mapping techniques in assisting diagnosis of ASS myocarditis.
methodsData from patients with ASS were retrospectively analysed. CMRI data for patients diagnosed with myocarditis, including late gadolinium enhancement (LGE), T2 ratio, T1 mapping, extracellular volume (ECV) and T2 mapping, were reviewed. Myocarditis was defined by the presence of symptoms and/or signs suggestive for heart involvement, including increased high-sensitive troponin T (hs-TnT) and/or N-terminal pro-brain natriuretic peptide (NT-proBNP), and at least an instrumental abnormality. The clinical features of patients with ASS with and without myocarditis were compared. A P-value of <0.05 was considered statistically significant.
resultsAmong a cohort of 43 patients with ASS [median age 58 (48.0-66.0) years; females 74.4%; anti-Jo1 53.5%], 13 (30%) were diagnosed with myocarditis. In 54% of those 13 patients, myocarditis was diagnosed at clinical onset. All patients with ASS with myocarditis had at least one CMRI abnormality: increased ECV in all cases, presence of LGE in 91%, and increased T1 and T2 mapping in 91%. The 2009 Lake Louise criteria (LLC) were satisfied by 6 patients, and the 2018 LLC by 10 patients. With the updated LLC, the sensitivity for myocarditis improved from 54.6% to 91.0%. Patients with ASS with myocarditis were more frequently males (53% vs 13%; P = 0.009) with fever (69% vs 17%; P = 0.001), and had higher hs-TnT [88.0 (23.55-311.5) vs 9.80 (5.0-23.0) ng/l; P < 0.001], NT-proBNP [525.5 (243.5-1575.25) vs 59.0 (32.0-165.5; P = 0.013) pg/ml; P = 0.013] and CRP [7.0 (1.7-15.75) vs 1.85 (0.5-2.86) mg/l; P = 0.011] compared with those without myocarditis.
conclusionIn ASS, myocarditis is frequent, even at clinical onset. Patients with ASS with myocarditis frequently presented with fever and increased CRP, suggesting the existence of an inflammatory phenotype. The use of novel CMRI mapping techniques may increase diagnostic sensitivity for myocarditis in ASS.
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