Document Detail


Cardiac tissue characterization and the diagnostic value of cardiovascular magnetic resonance in systemic connective tissue diseases.
MedLine Citation:
PMID:  24106233     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background-Aim. Accurate diagnosis of cardiovascular involvement in connective tissue diseases (CTD) remains challenging. We hypothesized that cardiovascular magnetic resonance (CMR) demonstrates cardiac lesions in symptomatic CTDs with normal echochardiography. Patients-Methods. CMR from 246 CTDs with typical (TCS) (n=146, group A) or atypical (ATCS) (n=100, group B) cardiac symptoms were retrospectively evaluated. Group A included 9 inflammatory myopathies (IM), 35 sarcoidosis (SRC), 30 systemic sclerosis (SSc), 14 systemic lupus erythematosus (SLE), 10 rheumatoid arthritis (RA) and 48 small vessel vasculitis. Group B included 25 RA, 20 SLE, 20 SRC, 15 SSc, 10 IM and 10 small vessel vasculitis. CMR was performed by 1.5 T; LV ejection fraction, T2 ratio (oedema imaging) and late gadolinium enhancement (LGE) (fibrosis imaging) were evaluated. Acute and chronic lesions were characterised as LGE-positive plus T2>2 or T2<2, respectively. According to LGE, lesions were characterized as: a) diffuse subendocardial, b) subepicardial and c) subendocardial/transmural, due to vasculitis, myocarditis and myocardial infarction, respectively. A stress study by dobecho, stress nuclear or adenosine CMR was performed in CTDs with negative rest CMR. Results. Abnormal CMR was identified in 32 % (chronic 27%) and 15 % (chronic12%) of TCS and ATCS, respectively. Lesions due to vasculitis, myocarditis and myocardial infarction were evident in 27.4%, 62.6% and 9.6% of CTDs, respectively. Stress studies in CTDs with negative CMR revealed coronary artery disease in 20%. Conclusions. CMR in symptomatic CTDs with normal echo can assess disease acuity and identify vasculitis, myocarditis and myocardial infarction. © 2013 American College of Rheumatology.
Authors:
Sophie Mavrogeni; Petros P Sfikakis; Elias Gialafos; Konstantinos Bratis; Georgia Karabela; Efthymios Stavropoulos; Georgios Spiliotis; Eliza Sfendouraki; Stylianos Panopoulos; Vasiliki Bournia; Genovefa Kolovou; George D Kitas
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-9-19
Journal Detail:
Title:  Arthritis care & research     Volume:  -     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-10-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 American College of Rheumatology.
Affiliation:
Onassis Cardiac Surgery Center, Athens, Greece.
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