Evaluation of myocardial involvement in patients with connective tissue disorders: a multi-parametric cardiovascular magnetic resonance study

Journal of Cardiovascular Magnetic Resonance

Research

Joerg Henes¹  Udo Sechtem²  Philipp Kaesemann²  Francesco Vecchio²  Heiko Mahrholdt²  Hannah Steubing²  Simon Greulich²  Alexandru Patrascu²  M. Dominik Alscher³  Joerg Latus³  Niko Braun³  Daniel Kitterer³  Agnes Mayr⁴  Stefan Groeninger⁵  Andreas Greiser⁵ 

[1] Centre for Interdisciplinary Clinical Immunology, Rheumatology and Auto-inflammatory Diseases and Department of Internal Medicine II (Oncology, Haematology, Immunology, Rheumatology, Pulmology), University Hospital Tuebingen, Tuebingen, Germany;Division of Cardiology, Robert-Bosch-Medical Center Stuttgart, Auerbachstrasse 110, 70376, Stuttgart, Germany;Division of Nephrology, Department of Internal Medicine, Robert-Bosch-Medical Center Stuttgart, Stuttgart, Germany;Division of Radiology, University Hospital Innsbruck, Innsbruck, Austria;Siemens Healthcare GmbH, Erlangen, Germany;

关键词: Connective tissue disorders;    Myocardial involvement;    CMR;    LGE;    Mapping;   

DOI  :  10.1186/s12968-016-0288-4

 received in 2016-06-29, accepted in 2016-09-29,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundSevere arrhythmias or heart failure may be surrogates of myocardial involvement in patients with connective tissue disorders (CTD). However, most patients present with unspecific symptoms, normal ECG, and preserved left ventricular ejection fraction (LV-EF). Therefore, timely diagnosis by an accurate technique is crucial. Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) has proven value for the detection of focal processes, but due to the often diffuse character of fibrosis/inflammation in CTD patients, CMR mapping techniques might be of incremental value for the assessment of myocardial involvement. Purpose of this study was to evaluate a multi-parametric CMR protocol as a screening tool for myocardial involvement in CTD patients.MethodsForty CTD patients were prospectively enrolled and underwent CMR, twenty healthy volunteers served as control group.ResultsMean LV-EF was 62 %; LGE prevalence was low (18 %). CTD patients had higher native T1 (1008 vs. 962 ms, p = 0.001), lower post contrast T1 (494 vs. 526 ms, p = 0.008), expanded extracellular volume (ECV) (28 vs. 25 %, p = 0.001), and higher T2 values (53 vs. 49 ms, p < 0.001) compared to controls. Among patients with values higher than the 95 % percentile of healthy controls, native T1 and T2 values seem to be the most promising discriminators.ConclusionCTD patients showed higher T1, ECV, and T2 values compared to controls, with most significant differences for native T1 and T2, which seem to be independent of the presence of LGE. Our data suggest that CMR mapping techniques are of incremental value in the detection of myocardial involvement in CTD patients.

【 授权许可】

CC BY   
© The Author(s). 2016