Περίληψη:
Background-aim Cardiac involvement at diagnosis of connective tissue disease (CTD) has been described by echocardiography. We hypothesized that cardio-vascular magnetic resonance (CMR) detects occult lesions at CTD diagnosis. Patients-methods CMR was performed early after diagnosis in 78 treatment-naïve CTDs (aged 43 ± 11, 59F/19M) without cardiac involvement [5 Takayasu arteritis (TA), 4 Churg Strauss syndrome (CSS), 5 Wegener granulomatosis (WG), 16 systemic lupus erythematosus (SLE), 12 rheumatoid arthritis (RA), 8 mixed connective tissue diseases (MCTD), 12 ankylosing spondylitis (AS), 3 polymyalgia rheumatica (PMR), 8 systemic sclerosis (SSc) and 5 dermatomyositis (DM)]. Acute and chronic lesions were assessed by T2 > 2 with positive LGE and T2 < 2 with positive LGE, respectively. Results In 3/5 TA, 3/4 CSS, 4/5 WG, 10/16 SLE, 9/12 RA, 6/8 MCTD, 4/12 AS, 1/3 PMR, 2/8 SSc and 2/5 DM, the T2 ratio was higher compared to normal (2.78 ± 0.25 vs 1.5 ± 0.2, p < 0.01). Myocarditis was identified in 1 TA, 1 SLE, 1 RA, 1 SSc and 2 DM patients; diffuse, subendocardial fibrosis in 1 CSS and 1 RA patient, while subendocardial myocardial infarction in 3 SLE, 1 MCTD, 1 PMR and 2 RA patients. CMR re-evaluation after 6 and 12 months of rheumatic and cardiac treatment, available in 28/52 CTDs with increased T2 ratio, showed significant improvement in T2 ratio (p < 0.001), non-significant change in LGE extent and normalisation of those with impaired LV function. Conclusions Occult CMR lesions, including oedema, myocarditis, diffuse subendocardial fibrosis and myocardial infarction are not unusual in treatment naïve CTDs and may be reversed with appropriate treatment. © 2017 Elsevier B.V.
Συγγραφείς:
Mavrogeni, S.
Markousis-Mavrogenis, G.
Koutsogeorgopoulou, L.
Dimitroulas, T.
Bratis, K.
Kitas, G.D.
Sfikakis, P.
Tektonidou, M.
Karabela, G.
Stavropoulos, E.
Katsifis, G.
Boki, K.A.
Kitsiou, A.
Filaditaki, V.
Gialafos, E.
Plastiras, S.
Vartela, V.
Kolovou, G.
Λέξεις-κλειδιά:
acute disease; adult; aged; ankylosing spondylitis; aorta arch syndrome; Article; cardiovascular magnetic resonance; chronic disease; Churg Strauss syndrome; connective tissue disease; dermatomyositis; diffuse subendocardial fibrosis; female; follow up; heart disease; heart edema; heart infarction; heart left ventricle failure; heart muscle fibrosis; human; major clinical study; male; mixed connective tissue disease; myocarditis; rheumatic polymyalgia; rheumatoid arthritis; systemic lupus erythematosus; systemic sclerosis; Wegener granulomatosis; cine magnetic resonance imaging; connective tissue disease; diagnostic imaging; echocardiography; electrocardiography; middle aged; pathophysiology; procedures; treatment outcome, Adult; Connective Tissue Diseases; Echocardiography; Electrocardiography; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging, Cine; Male; Middle Aged; Treatment Outcome
