心脏磁共振成像正常的免疫检查点抑制剂相关性心肌炎：心脏活检及早期诊断的重要性
Immune Checkpoint Inhibitor Myocarditis With Normal Cardiac Magnetic Resonance Imaging: Importance of Cardiac Biopsy and Early Diagnosis.
作者信息
Ederhy Stephane, Fenioux Charlotte, Cholet Clement, Rouvier Philippe, Redheuil Alban, Cohen Ariel, Salem Joe-Elie
机构信息
Department of Cardiology, Assistance Publique‒Hôpitaux de Paris, Saint-Antoine Hospital, Paris, France and Sorbonne Université, UNICO-GRECO Cardio-oncology Program, Paris, France.
Sorbonne Université, INSERM, CIC-1901 Paris-Est, UNICO-GRECO Cardio-oncology Program, Assistance Publique‒Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France.
出版信息
Can J Cardiol. 2021 Oct;37(10):1654-1656. doi: 10.1016/j.cjca.2020.12.022. Epub 2020 Dec 26.
Immune checkpoint inhibitors (ICIs) have improved the management and the prognosis of patients with cancer but are associated with an increased risk of toxicities that can affect every organ. ICI-associated myocarditis has a low incidence (< 1%) but a high fatality rate (30%-50%). Herein we report a patient treated with ICI admitted for suspicion of myocarditis. Cardiac magnetic resonance imaging (cMRI) was normal. An endomyocardial biopsy (EMB) was in favour of ICI-related myocarditis with cardiac lymphohistiocytic infiltrate. This case highlights the role of a systematic evaluation with electrocardiography and troponin and the potential value of EMB in patients without a suggestive cMRI.
免疫检查点抑制剂（ICI）改善了癌症患者的治疗和预后，但会增加影响各个器官的毒性风险。ICI相关的心肌炎发病率低（<1%），但死亡率高（30%-50%）。在此，我们报告一例接受ICI治疗的患者因疑似心肌炎入院。心脏磁共振成像（cMRI）结果正常。心内膜心肌活检（EMB）支持与ICI相关的心肌炎，伴有心脏淋巴细胞组织细胞浸润。该病例突出了心电图和肌钙蛋白系统评估的作用以及EMB在cMRI无提示意义患者中的潜在价值。
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