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Native Myocardial T1 Mapping by Cardiovascular Magnetic Resonance Imaging in Subclinical Cardiomyopathy in Patients with Systemic Lupus Erythematosus.
MedLine Citation:
PMID:  23403334     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -Increased systemic inflammation has been linked to myocardial dysfunction and heart failure in patients with systemic lupus erythematosus (SLE). Accurate detection of early myocardial changes may be able to guide preventive intervention. We investigated whether multiparametric imaging by cardiovascular magnetic resonance (CMR) can detect differences between controls and asymptomatic SLE patients. METHODS AND RESULTS: -A total of 33 SLE predominantly female patients (mean age 40±9 years) underwent CMR for routine assessment of myocardial perfusion, function and late gadolinium enhancement (LGE). T1 mapping was performed in single short axis slice before and 15 minutes after gadolinium administration. Twenty-one subjects with a low pre-test probability and normal CMR acted as a control group. Both groups had similar LV volumes and mass and normal global systolic function. SLE patients had significantly reduced longitudinal strain (controls vs. SLE: %, -20±2 vs. -17±3 p<0.01) and showed intramyocardial and pericardial LGE. SLE patients had significantly increased native myocardial T1 (msec, 1056±27 vs. 1152±46, p<0.001) and extracellular volume fraction (%, 26±5 vs. 30±6; p=0.007), and reduced postcontrast myocardial T1 (msec, 454±53 vs. 411±62, p=0.01). T1-derived indices were associated with longitudinal strain (r=0.37-0.47), but not with the presence of LGE. Native myocardial T1 values showed the greatest concordance with the presence of clinical diagnosis of SLE. CONCLUSIONS: -In patients with SLE and free of cardiac symptoms there is evidence of subclinical perimyocardial impairment. We further demonstrate that T1 mapping may bear a potential to detect subclinical myocardial involvement in patients with SLE.
Authors:
Valentina O Puntmann; David D'Cruz; Zachary Smith; Ana Pastor; Peng Choong; Tobias Voigt; Gerry Carr-White; Shirish Sangle; Tobias Schaeffter; Eike Nagel
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-12
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1King's College London, London, United Kingdom.
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