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Cardiac and muscular involvement in idiopathic inflammatory myopathies: noninvasive diagnostic assessment and the role of cardiovascular and skeletal magnetic resonance imaging.
[inclusion body myositis]
Idiopathic
inflammatory
myopathies
(
IIMs
)
are
rare
autoimmune
diseases
and
include
dermatomyositis
,
polymyositis
,
necrotizing
myopathy
and
inclusion
body
myositis
;
they
are
characterized
by
inflammation
of
skeletal
muscle
and
other
internal
organs
and
may
potentially
lead
to
irreversible
damage
and
death
.
Only
a
small
percentage
of
IIM
has
clinically
overt
cardiac
disease
;
however
,
heart
involvement
is
one
of
the
leading
causes
of
death
and
therefore
,
early
detection
remains
a
challenge
.
Biochemical
markers
and
non-invasive
methods
such
as
the
electrocardiogram
and
echocardiography
have
a
role
in
diagnosis
,
but
lack
sensitivity
in
identifying
patients
with
early
,
sublinical
cardiac
abnormalities
.
Endomyocardial
and
skeletal
muscle
biopsies
are
very
useful
,
but
invasive
techniques
and
can
not
be
used
for
routine
follow-up
.
Cardiac
and
skeletal
magnetic
resonance
imaging
,
due
to
their
capability
to
perform
tissue
characterization
,
has
emerged
as
novel
techniques
for
the
early
detection
and
follow-up
of
myocardial
and
skeletal
muscle
tissue
changes
(
oedema
,
inflammation
,
fibrosis
)
in
IIM
.
However
,
the
clinical
implications
of
using
these
approaches
and
their
cost
/
benefit
ratio
require
further
evaluation
.
Diseases
Validation
Diseases presenting
"small percentage"
symptom
adrenal incidentaloma
cushing syndrome
cystinuria
holt-oram syndrome
inclusion body myositis
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