1
|
Tabata T, Kiuchi K, Nagamatsu Y, Shinkura Y, Uzu K, Ooka JI, Shimoyama S, Nishii T, Mori S, Hirata KI, Tsujimoto M, Tajima S, Nakano E, Nishigori C, Yamamoto Y, Hara S. A case of acute heart failure due to myocardial infiltration of mycosis fungoides. J Cardiol Cases 2018; 18:95-98. [PMID: 30279921 DOI: 10.1016/j.jccase.2018.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 11/26/2022] Open
Abstract
Mycosis fungoides (MF) has been reported to be the most common cutaneous lymphoma with a good prognosis and myocardial infiltration is clinically rare. We hereby report a case of rapidly progressing acute heart failure due to myocardial infiltration by MF. Perfusion cardiac magnetic resonance imaging (MRI) demonstrated a massive perfusion defect in the left ventricle (LV) where multiple nodular enhancement areas by delayed enhancement MRI could be documented in the postero-lateral wall of the LV, which resulted in a deterioration of the LV function and mitral regurgitation. Autopsy confirmed the myocardial infiltration by the MF, which corresponded with the MRI findings. <Learning objective: Symptomatic heart failure patients with myocardial infiltration by mycosis fungoides (MF) have a poor prognosis because they could not undergo chemotherapy for primary disease. Therefore, early diagnosis is important for improvement of prognosis. The routine assessment of the cardiac involvement by cardiac magnetic resonance imaging as well as transthoracic echocardiography should be performed for an early recognition of myocardial infiltration even in asymptomatic MF patients.>.
Collapse
Affiliation(s)
- Tokiko Tabata
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiology, Kobe, Hyogo, Japan
| | - Kunihiko Kiuchi
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiology, Kobe, Hyogo, Japan
| | - Yuichi Nagamatsu
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiology, Kobe, Hyogo, Japan
| | - Yuto Shinkura
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiology, Kobe, Hyogo, Japan
| | - Kenzou Uzu
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiology, Kobe, Hyogo, Japan
| | - Jun-Ichi Ooka
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiology, Kobe, Hyogo, Japan
| | - Shinsuke Shimoyama
- Kobe University Graduate School of Medicine, Department of Radiology, Kobe, Hyogo, Japan
| | - Tatsuya Nishii
- Kobe University Graduate School of Medicine, Department of Radiology, Kobe, Hyogo, Japan
| | - Shumpei Mori
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiology, Kobe, Hyogo, Japan
| | - Ken-Ichi Hirata
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiology, Kobe, Hyogo, Japan
| | - Mariko Tsujimoto
- Kobe University Graduate School of Medicine, Department of Internal Related, Division of Dermatology, Kobe, Hyogo, Japan
| | - Shoko Tajima
- Kobe University Graduate School of Medicine, Department of Internal Related, Division of Dermatology, Kobe, Hyogo, Japan
| | - Eiji Nakano
- Kobe University Graduate School of Medicine, Department of Internal Related, Division of Dermatology, Kobe, Hyogo, Japan
| | - Chikako Nishigori
- Kobe University Graduate School of Medicine, Department of Internal Related, Division of Dermatology, Kobe, Hyogo, Japan
| | - Yuki Yamamoto
- Kobe University Graduate School of Medicine, Department of Pathology, Kobe, Hyogo, Japan
| | - Shigeo Hara
- Kobe University Graduate School of Medicine, Department of Pathology, Kobe, Hyogo, Japan
| |
Collapse
|
2
|
Wang C, Han S, Xu T, Wang F, Wang X, Chen J, Hu C, Li D. Evaluation of myocardial viability in old myocardial infarcted patients with CHF: delayed enhancement MRI vs. low-dose dobutamine stress speckle tracking echocardiography. Am J Transl Res 2016; 8:3731-3743. [PMID: 27725854 PMCID: PMC5040672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 07/13/2016] [Indexed: 06/06/2023]
Abstract
The aim of this study was to explore the significance of delayed enhancement magnetic resonance imaging (DE-MRI) combined with two-dimensional speckle tracking echocardiography (STE) and low dose dobutamine stress echocardiography (LDDSE) to assess viable myocardium (VM) in the patients with old myocardial infarction (OMI) associated with congestive heart failure (CHF). Thirty five hospitalized OMI patients with regional wall motion abnormalities and left ventricular ejection fraction (LVEF) < 50% were recruited based on routine echocardiography. The results showed that DE-MRI facilitated the detection of VM, with a sensitivity, specificity and accuracy of 92.41%, 89.19% and 91.32%, respectively. In a parallel test of the two main parameters in STE, the sensitivity, specificity, and accuracy were improved from baseline to LDDSE (71.72% vs. 91.72%, 70.27% vs. 85.14%, and 71.23% vs. 89.50%, P < 0.05). A parallel test involving STE with LDDSE showed high sensitivity for VM. However its specificity and accuracy were lower than DE-MRI, even when combined with LDDSE. Therefore, combining these two methods, improves the sensitivity, specificity and accuracy for assessment of VM. The combination approach is the best option for the evaluation of VM using serial test. It provides further treatment options and prognosis of patients with OMI. LVEF is improved significantly after PCI in OMI patients with VM and CHF.
Collapse
Affiliation(s)
- Chaofan Wang
- Institute of Cardiovascular Disease Research, Xuzhou Medical UniversityJiangsu Province, P. R. China
| | - Shuguang Han
- Department of Radiology of Affiliated Hospital of Xuzhou Medical UniversityJiangsu Province, P. R. China
| | - Tongda Xu
- Department of Cardiology of Affiliated Hospital of Xuzhou Medical UniversityJiangsu Province, P. R. China.
| | - Fengli Wang
- Institute of Cardiovascular Disease Research, Xuzhou Medical UniversityJiangsu Province, P. R. China
| | - Xiaoping Wang
- Department of Cardiology of Affiliated Hospital of Xuzhou Medical UniversityJiangsu Province, P. R. China.
| | - Jing Chen
- Department of Cardiology of Affiliated Hospital of Xuzhou Medical UniversityJiangsu Province, P. R. China.
| | - Chunfeng Hu
- Department of Radiology of Affiliated Hospital of Xuzhou Medical UniversityJiangsu Province, P. R. China
| | - Dongye Li
- Institute of Cardiovascular Disease Research, Xuzhou Medical UniversityJiangsu Province, P. R. China
| |
Collapse
|