Bortezomib-Induced Myocarditis in a Patient With Multiple Myeloma

Figures

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  Figure 1. Initial and Follow-Up Echocardiography (A) Echocardiogram demonstrating severely reduced left ventricular systolic function (LVEF: 35%, GLS: –10%) with global hypokinesia. (B) Follow-up echocardiogram showing improved systolic function (LVEF: 52%, GLS: –17%). GLS = global longitudinal strain; LVEF = left ventricular ejection fraction.

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  Figure 2. Mitral Inflow Pulsed-Wave Doppler TTE TTE apical view with pulsed-wave Doppler at the mitral leaflet tips demonstrating early diastolic filling (E = 1.35 m/s) and atrial contraction velocity (A = 0.71 m/s), with an E/A ratio of 1.9 and deceleration time (TD) of 155 ms, suggesting grade III diastolic dysfunction. TTE = transthoracic echocardiography.

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  Figure 3. Cardiac Magnetic Resonance Imaging (A) LGE sequence in the 4-chamber view showing a heterogeneous pattern with intramyocardial and subepicardial enhancement. (B) LGE sequence in the 3-chamber view revealing a similar heterogeneous intramyocardial and subepicardial enhancement pattern. (C) T2-mapping sequence with increased myocardial relaxation times (mean: 63.89 ms, range: 49.50-93.90 ms, reference: 45-55 ms at 1.5 T or 50-60 ms at 3 T). (D) T1-mapping sequence with elevated myocardial relaxation times (mean: 1,202.92 ms, range: 1,099-1,346 ms, reference: 950-1,050 ms at 1.5 T or 1,150-1,300 ms at 3 T. (E) Cine 4-chamber view revealing mild pericardial effusion. LGE = late gadolinium enhancement.