Magnetic resonance is becoming an increasingly used examination in cardiology, since it greatly improves the accuracy of diagnosing of many heart diseases. At present magnetic resonance is the gold standard in assessing the volumes of the heart chambers and the systolic function of both ventricles. The possibility of detecting tissue characteristics to refine the diagnostics of different types of myocardial pathology is of essential importance. The authors summarize in the article the present knowledge about the use of magnetic resonance of the heart in the field of myocardial disease, i.e. cardiomyopathy and myocarditis. In the first of this article, a general overview of cardiac magnetic resonance examination has been given, followed by detailed description of its usefulness in dilated cardiomyopathy and myocarditis, in hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy. The second part of the review summarizes the benefits of cardiac magnetic resonance examination in cardiac amyloidosis and other less common cardiomyopathies.Key words: fibrosis - cardiomyopathy - magnetic resonance - myocarditis - late contrast agent saturation.

• MeSH
• hypertrofická kardiomyopatie diagnostické zobrazování   MeSH
• kardiologie metody   MeSH
• kardiomyopatie diagnostické zobrazování   patologie   MeSH
• kardiovaskulární abnormality diagnostické zobrazování   MeSH
• lidé MeSH
• magnetická rezonanční tomografie * MeSH
• myokarditida diagnostické zobrazování   patologie   MeSH
• srdeční komory diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

AIMS: To compare the differences between patients with inflammatory cardiomyopathy (ICM) with and without improvement in left ventricular (LV) systolic function and to identify the relevant predictors of LV improvement. PATIENTS AND METHODS: The study included 63 patients with biopsy-proven ICM and heart failure symptoms of at least NYHA II, symptom duration ≤ 6 months, LV ejection fraction (LVEF) ≤ 40% assessed by echocardiography and presence of >14 mononuclear leukocytes (LCA+ cells)/mm2 in biopsy samples. Patients were evaluated at baseline and after 6 months. RESULTS: In the group with LVEF improvement of ≥ 10% (I+ group, n = 41), LVEF increased from 24 ± 7% to 47 ± 8% (P < 0.001). In 22 patients (group I-), there was no or minimal LVEF increase (< 10%). In the I+ group, there were more LCA+ cells/mm2 at baseline (25.1 ± 16.5 vs. 18.5 ± 4.4 cells/mm2; P = 0.032) and a more significant decrease in LCA+ cells in the follow-up (reduction of 13.6 ± 14.3 cells/mm2 vs. 5.0 ± 7.7 cells/mm2 in the I- group; P = 0.009). The univariate logistic regression showed a possible association of number of LCA+ cells, LV end-diastolic diameter and N-terminal fragment of pro-brain natriuretic peptide (NTproBNP) value with LVEF improvement. In the multivariate analysis, only NTproBNP at diagnosis was confirmed as an independent predictor of LVEF improvement (OR=1.2; 1.003 to 1.394; P = 0.046). CONCLUSION: The LV systolic function improvement was observed in 65% of the patients. In these patients, the number of inflammatory cells at baseline was higher and decreased more but the higher baseline NTproBNP value was the only independent predictor of LVEF improvement.

• Klíčová slova
• NTproBNP, echocardiography, endomyocardial biopsy, inflammatory cardiomyopathy, right heart catheterization.,
• MeSH
• dospělí MeSH
• dysfunkce levé srdeční komory diagnostické zobrazování   patofyziologie   terapie   MeSH
• echokardiografie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• myokarditida diagnostické zobrazování   patofyziologie   terapie   MeSH
• natriuretický peptid typu B metabolismus   MeSH
• obnova funkce MeSH
• peptidové fragmenty metabolismus   MeSH
• senioři MeSH
• srdeční selhání diagnostické zobrazování   patofyziologie   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• natriuretický peptid typu B MeSH
• peptidové fragmenty MeSH
• pro-brain natriuretic peptide (1-76) MeSH Prohlížeč

Magnetic resonance is becoming an increasingly used examination in cardiology, since it greatly improves the accuracy of diagnosing of many heart diseases. At present magnetic resonance is the gold standard in assessing the volumes of the heart chambers and the systolic function of both ventricles. The possibility of detecting tissue characteristics to refine the diagnostics of different types of myocardial pathology is of essential importance. The authors summarize in the article the present knowledge about the use of magnetic resonance of the heart in the field of myocardial disease, i.e. cardiomyopathy and myocarditis. The first part of the review gives a general introduction into the topic of magnetic resonance examination of myocardial diseases, which is followed by a detailed descrip-tion of the benefits of this imaging method in dilated cardiomyopathy and myocarditis,in hypertrophic cardio-myopathy, and arrhythmogenic right ventricular cardiomyopathy.Key words: fibrosis - cardiomyopathy - magnetic resonance - myocarditis - late contrast agent saturation.

• MeSH
• arytmogenní dysplazie pravé komory diagnostické zobrazování   patofyziologie   MeSH
• dilatační kardiomyopatie diagnostické zobrazování   patofyziologie   MeSH
• hypertrofická kardiomyopatie diagnostické zobrazování   patofyziologie   MeSH
• kardiologie MeSH
• kardiomyopatie diagnostické zobrazování   patofyziologie   MeSH
• kontrastní látky MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• myokarditida diagnostické zobrazování   patofyziologie   MeSH
• srdce - funkce komor MeSH
• srdce diagnostické zobrazování   patofyziologie   MeSH
• systola MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• kontrastní látky MeSH

Patients with myocarditis and left ventricular (LV) dysfunction may improve after standard heart failure therapy. This improvement seems to be related to retreat of myocardial inflammation. The aim of the present study was to assess changes in clinical, echocardiographic and some laboratory parameters and to correlate them with changes in the number of inflammatory infiltrating cells in endomyocardial biopsy (EMB) samples during the 6-month follow-up, and to define predictors of LV function improvement among baseline parameters. Forty patients with biopsy-proven myocarditis and impaired LV function (LV ejection fraction-LVEF <40 %) with heart failure symptoms ≤ 6 months were evaluated. Myocarditis was defined as the presence of >14 mononuclear leukocytes/mm(2) and/or >7 T-lymphocytes/mm(2) in the baseline EMB. The EMB, echocardiography and clinical evaluation were repeated after 6 months of standard heart failure therapy. LVEF improved on average from 25 ± 9 to 42 ± 12 % (p < 0.001); LV end-systolic volume and LV end-diastolic volume (LVEDV) decreased from 158 ± 61 to 111 ± 58 ml and from 211 ± 69 to 178 ± 63 ml (both p < 0.001). NYHA class decreased from 2.6 ± 0.5 to 1.6 ± 0.6 (p < 0.001) and NTproBNP from 2892 ± 3227 to 851 ± 1835 µg/ml (p < 0.001). A decrease in the number of infiltrating leukocytes (CD45+/LCA+) from 23 ± 15 to 13 ± 8 cells/mm(2) and in the number of infiltrating T lymphocytes (CD3+) from 7 ± 5 to 4 ± 3 cells/mm(2) (both p < 0.001) was observed. The decline in the number of infiltrating CD45+ cells significantly correlated with the change in LVEF (R = -0.43; p = 0.006), LVEDV (R = 0.39; p = 0.012), NYHA classification (R = 0.35; p = 0.025), and NTproBNP (R = 0.33; p = 0.045). The decrease in the number of CD3+ cells correlated with the change of systolic and diastolic diameters of the left ventricle (R = -0.33; p = 0.038 and R = -0.45; p = 0.003) and with the change in LVEDV (R = -0.43; p = 0.006). Tricuspid annular plane systolic excursion (TAPSE) (OR 0.61; p = 0.005) and early transmitral diastolic flow velocity (E wave) (OR 0.89; p = 0.002) were identified as predictors of LVEF improvement. Improvements in clinical status, LV function and NTproBNP levels correlated with decrease in the number of infiltrating inflammatory cells. TAPSE and E wave velocity were significant predictors of improvement in multivariate regression. Our observations suggest that contemporary guidelines-based therapy of heart failure is an effective treatment option in patients with recent onset biopsy-proven inflammatory cardiomyopathy.

• Klíčová slova
• Echocardiography, Endomyocardial biopsy, Inflammatory cardiomyopathy, Left ventricular dysfunction, Myocarditis,
• MeSH
• biologické markery krev   MeSH
• biopsie MeSH
• časové faktory MeSH
• chemotaxe leukocytů MeSH
• dopplerovská echokardiografie * MeSH
• dospělí MeSH
• dysfunkce levé srdeční komory diagnóza   diagnostické zobrazování   farmakoterapie   patologie   MeSH
• funkce levé komory srdeční * účinky léků   MeSH
• kardiomyopatie diagnóza   diagnostické zobrazování   farmakoterapie   patologie   MeSH
• kardiovaskulární látky terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• multivariační analýza MeSH
• myokard metabolismus   patologie   MeSH
• myokarditida diagnóza   diagnostické zobrazování   farmakoterapie   patologie   MeSH
• natriuretický peptid typu B krev   MeSH
• obnova funkce MeSH
• odds ratio MeSH
• peptidové fragmenty krev   MeSH
• prediktivní hodnota testů MeSH
• rizikové faktory MeSH
• srdeční selhání diagnóza   diagnostické zobrazování   farmakoterapie   patologie   MeSH
• T-lymfocyty patologie   MeSH
• tepový objem * účinky léků   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biologické markery MeSH
• kardiovaskulární látky MeSH
• natriuretický peptid typu B MeSH
• peptidové fragmenty MeSH
• pro-brain natriuretic peptide (1-76) MeSH Prohlížeč