T1 and T2 mapping for evaluation of myocardial involvement in patients with ANCA-associated vasculitides

Journal of Cardiovascular Magnetic Resonance

Research

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

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

关键词: ANCA-associated vasculitides;    Cardiac involvement;    CMR;    LGE;    T1 mapping;    T2 mapping;   

DOI  :  10.1186/s12968-016-0315-5

 received in 2016-10-16, accepted in 2016-12-09,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMyocardial involvement in AAV patients might be silent, presenting with no or nonspecific symptoms, normal ECG, and preserved left-ventricular ejection fraction (LV-EF). Since up to 50% of deaths in these patients may be due to myocardial involvement, a reliable diagnostic tool is warranted. In contrast to LGE-CMR, which has its strengths in detecting focal inflammatory or fibrotic processes, recent mapping techniques are able to detect even subtle, diffuse inflammatory or fibrotic processes. Our study sought to investigate ANCA (antineutrophil cytoplasmic antibody) associated vasculitides (AAV) patients for myocardial involvement by a cardiovascular magnetic resonance (CMR) protocol, including late gadolinium enhancement (LGE) and mapping sequences.MethodsThirty seven AAV patients were prospectively enrolled and underwent CMR imaging. Twenty healthy volunteers served as controls.ResultsMean LV-EF was 64%; LGE prevalence of the AAV patients was 43%. AAV patients had higher median native T1 (988 vs. 952 ms, p < 0.001), lower post-contrast T1 (488 vs. 524 ms, p = 0.03), expanded extracellular volume (ECV) (27.5 vs. 24.5%, p < 0.001), and higher T2 (53 vs. 49 ms, p < 0.001) compared to controls, with most parameters independent of the LGE status. Native T1 and T2 in AAV patients showed the highest prevalence of abnormally increased values beyond the 95% percentile of controls.ConclusionAAV patients demonstrated increased T1, ECV, and T2 values, with native T1 and T2 showing the highest prevalence of values beyond the 95% percentile of normal. Since these findings seem to be independent of LGE, mapping techniques may provide complementary information to LGE-CMR in the assessment of myocardial involvement in patients with AAV.

【 授权许可】

CC BY   
© The Author(s). 2017