Multiparametric cardiac magnetic resonance imaging (CMR) for the diagnosis of Loeffler's endocarditis: a case report.
BACKGROUND
Endocarditis parietalis fibroplastica Löfflein (EPF) is a rare form of primary restrictive cardiomyopathy with poor prognosis. It is generally caused by hypereosinophilic syndrome with eosinophilic penetration of the heart. This leads to congestive heart failure in three different stages. As a frequent manifestation of neoplastic diseases, cardiac involvement means poor prognosis.


CASE PRESENTATION
The present report deals with a case of EPF caused by non-specified T-cell lymphoma (T-NOS). Besides an elevated Troponin-T enzyme, the electrocardiogram and the transthoracic echocardiography did not show any characteristic results. Due to risk/benefit assessment and low thrombocyte amounts, endomyocardial biopsy and catheterization were discarded. Using cardiovascular magnetic resonance (CMR) with steady-state free precession sequences, T2-mappping, strain analysis and late gadolinium enhancement, we were able to clearly highlight cardiac involvement at different stages. These findings characterized T-NOS as a palliative situation.


CONCLUSION
Multiparametric CMR can not only identify EPF but also characterize the patchy disease state. This provides an individual prognosis assessment. Aside from prognosis estimation, it can also be used for therapy monitoring.
['Gastl|Mareike|M|0000-0002-7854-8418', 'Behm|Patrick|P|', 'Jacoby|Christoph|C|', 'Kelm|Malte|M|', 'Bönner|Florian|F|']
D000328:Adult D003287:Contrast Media D006338:Heart Neoplasms D006801:Humans D017681:Hypereosinophilic Syndrome D007166:Immunosuppressive Agents D016399:Lymphoma, T-Cell D019028:Magnetic Resonance Imaging, Cine D008297:Male D011237:Predictive Value of Tests D016896:Treatment Outcome
CMR Case report Restrictive cardiomyopathy Hypereosinophilic syndrome Heart failure Fibrosis Loeffler’s endocarditis