| Impact of cardiac magnetic resonance imaging for assessment of Churg-Strauss syndrome: a cross-sectional study in 20 patients. | |
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MedLine Citation:
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PMID: 19646350 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To examine the diagnostic contributions of cardiac magnetic resonance imaging (CMRI) with delayed-enhancement (DE) in patients with Churg-Strauss syndrome (CSS).METHODS: We consecutively recruited 14 men and 6 women (mean age: 50+/-14 years) with CSS (mean disease duration: 4.5+/-3.6 years) and investigated them independently of the presence/absence of cardiac manifestations. Cardiac manifestations included heart failure in 6 patients, angina pectoris in 1, isolated ECG abnormality in 1, and isolated echocardiography and ECG abnormalities in 1. T1-weighted sequences were recorded after gadolinium injection to study myocardial DE. RESULTS: CMRI abnormalities were found in 13/20 patients, including all 9 patients with myocardial manifestations, and 4 of the 11 asymptomatic patients. DE was centromyocardial in 6 patients, subepicardial in 4, and subendocardial in 3. Most enhanced lesions were in the anteroseptal or lateral walls. Patients with myocardial symptoms and DE had higher transmyocardial wall DE scores (mean: 9.4 vs. 3.7, respectively; p=0.01) and lower left ventricular ejection fractions (mean: 42% vs. 59%; p=0.001) than asymptomatic patients with DE. CONCLUSION: CMRI with DE enabled the detection of myocardial involvement in CSS patients with or without clinical symptoms. The clinical relevance of CMRI abnormalities in patients without clinical, echocardiographic and ECG signs of cardiac involvement remains unknown and needs to be evaluated in future studies. It seems premature to intensify treatment or to prescribe systematically steroids and cytotoxic agents based on the presence of isolated CMRI anomalies. |
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Authors:
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J Marmursztejn; O Vignaux; P Cohen; P Guilpain; C Pagnoux; H Gouya; L Mouthon; P Legmann; D Duboc; L Guillevin |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical and experimental rheumatology Volume: 27 ISSN: 0392-856X ISO Abbreviation: Clin. Exp. Rheumatol. Publication Date: 2009 Jan-Feb |
Date Detail:
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Created Date: 2009-08-03 Completed Date: 2010-02-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8308521 Medline TA: Clin Exp Rheumatol Country: Italy |
Other Details:
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Languages: eng Pagination: S70-6 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris, France. julien.marmursztejn@cch.aphp.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Churg-Strauss Syndrome / complications, diagnosis*, physiopathology Coronary Angiography Cross-Sectional Studies Echocardiography Female Heart Diseases / diagnosis*, etiology, physiopathology Humans Magnetic Resonance Angiography / methods* Male Middle Aged Myocardium / pathology* Ventricular Dysfunction, Left / diagnosis, etiology |
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