Detection of Myocardial Fibrosis in Systemic Sclerosis by Contrast-Enhanced Magnetic Resonance Imaging

Naßenstein, Kai; Breuckmann, Frank; Huger, Michael; Ladd, Susanne C.; Schlosser, T.; Kreuter, Alexander; Barkhausen, Jörg

doi:10.1055/s-2008-1027864

Cited by 28 publications

(13 citation statements)

References 24 publications

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“…and SSc (140)(141)(142)(143)(144)(145)(146)(147)(148)(149)(150). In many cases, CMR is thought to have identified cardiac disease acuity and myocardial inflammation-fibrosis, undetected by routinely used imaging techniques, thus facilitating risk stratification of the patients (125).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Cardiovascular magnetic resonance in rheumatology: Current status and recommendations for use

Mavrogeni

Kitas

Dimitroulas

et al. 2016

International Journal of Cardiology

120

111

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Targeted therapies in connective tissue diseases (CTDs) have led to improvements of disease-associated outcomes, but life expectancy remains lower compared to general population due to emerging co-morbidities, particularly due to excess cardiovascular risk. Cardiovascular magnetic resonance (CMR) is a noninvasive imaging technique which can provide detailed information about multiple cardiovascular pathologies without using ionizing radiation. CMR is considered the reference standard for quantitative evaluation of left and right ventricular volumes, mass and function, cardiac tissue characterization and assessment of thoracic vessels; it may also be used for the quantitative assessment of myocardial blood flow with high spatial resolution and for the evaluation of the proximal coronary arteries. These applications are of particular interest in CTDs, because of the potential of serious and variable involvement of the cardiovascular system during their course. The International Consensus Group on CMR in Rheumatology was formed in January 2012 aiming to achieve consensus among CMR and rheumatology experts in developing initial recommendations on the current state-of-the-art use of CMR in CTDs. The present report outlines the recommendations of the participating CMR and rheumatology experts with regards to: (a) indications for use of CMR in rheumatoid arthritis, the spondyloarthropathies, systemic lupus erythematosus, vasculitis of small, medium and large vessels, myositis, sarcoidosis (SRC), and scleroderma (SSc); (b) CMR protocols, terminology for reporting CMR and diagnostic CMR criteria for assessment and quantification of cardiovascular involvement in CTDs; and (c) a research agenda for the further development of this evolving field.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Cardiovascular magnetic resonance in rheumatology: Current status and recommendations for use

Mavrogeni

Kitas

Dimitroulas

et al. 2016

International Journal of Cardiology

120

111

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“…5,6 The detection of myocardial fibrosis early in the course of the disease is important, as appropriate medical therapy may slow the progression of the disease. [9][10][11] Limited information is available regarding the association between pulmonary and myocardial fibrosis in patients with SS. Principal among these is cardiac magnetic resonance imaging (CMR).…”

mentioning

confidence: 99%

Pulmonary Fibrosis in Systemic Sclerosis

Nicholson¹,

Hegarty²,

Jackson³

et al. 2012

Journal of Thoracic Imaging

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“…Our previous study showed that asymptomatic myocardial abnormalities could be complications of SSc . Similarly, previous studies reported that asymptomatic myocardial abnormalities (myocardial fibrosis) could be detected using late gadolinium enhancement (LGE) by CMRI in patients with SSc .…”

Section: Introductionmentioning

confidence: 72%

Association of cardiac magnetic resonance‐detected myocardial abnormalities with disease characteristics and brain natriuretic peptide levels in systemic sclerosis without cardiac symptoms

Sugiyama

Kobayashi

et al. 2019

Int J of Rheum Dis

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Aim:This study aimed to evaluate the association between myocardial abnormalities and left ventricular (LV) geometry as assessed using cardiac magnetic resonance imaging (CMRI) in systemic sclerosis (SSc) patients without cardiac symptoms.Methods: SSc patients without cardiac symptoms or cardiovascular risk factors underwent contrast CMRI. CMRI were assessed for structural and functional LV parameters and myocardial fibrosis based on myocardial late gadolinium enhancement (LGE). The correlation between brain natriuretic peptide (BNP) levels and LGE status was evaluated.Results: Among 49 patients, 27 (55%) showed LGE positivity. The most common identified LGE pattern was a linear pattern.LGE was not consistent with coronary artery distribution. There was no difference in ejection fraction between those with and without LGE. LV morphological changes were observed in 29% of SSc patients.An abnormal LV structure was detected in 44% and 14% of patients in the LGE+ andLGE− groups, respectively. The BNP levels were higher by 57% in the LGE+ group than in the LGE−group. Receiver operating characteristic analysis showed that BNP levels reliably detected myocardial abnormalities (area under the curve, 0.72; 95% confidence interval 0.58-0.88). Conclusions:Myocardial abnormalities were common in SSc patients without cardiac symptoms. We suggest that LV morphological changes may have resulted from myocardial abnormalities. BNP may be useful as a screening tool for the detection of myocardial abnormalities in SSc patients.

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Detection of Myocardial Fibrosis in Systemic Sclerosis by Contrast-Enhanced Magnetic Resonance Imaging

Abstract: Our results revealed a significantly higher number of LGE positive segments in patients with SSc compared to matched controls, and demonstrate the ability of contrast-enhanced MRI to detect myocardial fibrosis, the hallmark of scleroderma heart disease, in-vivo.

Cited by 28 publications

References 24 publications

Cardiovascular magnetic resonance in rheumatology: Current status and recommendations for use

Cardiovascular magnetic resonance in rheumatology: Current status and recommendations for use

Pulmonary Fibrosis in Systemic Sclerosis

Association of cardiac magnetic resonance‐detected myocardial abnormalities with disease characteristics and brain natriuretic peptide levels in systemic sclerosis without cardiac symptoms

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