High-sensitive troponin is associated with subclinical imaging biosignature of inflammatory cardiovascular involvement in systemic lupus erythematosus

Winau, L.; Baydes, R Hinojar; Braner, Axel; Drott, Ulrich; Burkhardt, Harald; Sangle, Shirish; D’Cruz, David; Carr‐White, Gerry; Marber, Michael; Schnoes, Katrin; Arendt, Christophe; Klingel, Karin; Vogl, Thomas J.; Zeiher, Andreas M.; Nagel, Eike; Püntmann, Valentina O.

doi:10.1136/annrheumdis-2018-213661

Cited by 59 publications

(42 citation statements)

References 57 publications

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“…Measuring cTnT and cTnI provides complementary information. Elevations in highly sensitive cTnT assays have been correlated with subclinical diffuse myocardial fibrosis and inflammation identified by MRI [ 14 ]. Additionally, cTnT elevations can be seen in active myositis without detectable myocardial inflammation, as presented in this report.…”

Section: Discussionmentioning

confidence: 99%

“…Elevation of cTnI should prompt further diagnostic workup, as this is less likely to be observed in the absence of myocardial injury [ 3 ]. Cardiac MRI has also become an important diagnostic modality in detecting myocardial disease in lupus [ 14 – 17 ]. Even in the absence of TTE abnormalities, cardiac MRI can demonstrate lesions, including myocarditis and vasculitis as well as hemodynamic parameters such as ventricular stiffness [ 14 – 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain

Katz

Kolasinski

Sundaram

et al. 2020

Case Reports in Rheumatology

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Patients with systemic lupus erythematosus (SLE) presenting with chest pain pose a unique diagnostic challenge, with causes ranging from cardiopulmonary disease to esophageal disorders and musculoskeletal chest wall pain. The most common biomarkers for myocardial injury are cardiac troponin T and I (cTnT and cTnI) due to their high sensitivity for the early detection of myocardial infarction. In the idiopathic inflammatory myopathies, cTnT is commonly elevated, and this reflects skeletal muscle breakdown rather than myocardial damage. Similar observations have not been reported in SLE myositis to date. We present two cases of patients with SLE and associated myositis who presented with chest pain and elevated cTnT. Both patients had a normal cTnI, transthoracic echocardiogram, and cardiac magnetic resonance imaging, likely indicating noncardiac chest pain. Clinicians should be aware that the specificity of cTnT might be lower in SLE myositis and that cTnI elevation may be more specific in detecting myocardial insult.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain

Katz

Kolasinski

Sundaram

et al. 2020

Case Reports in Rheumatology

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“…Frequently pericarditis can be the first clinical expression of a malignancy [17]. A more subclinical course of pericarditis is often seen in patients with autoimmune diseases, like systemic lupus erythematosus (SLE), and which is accompanied by myocarditis [18]. LGE imaging is also an effective CMR technique to guide treatment of pericarditis [19].…”

Section: Pericarditis and Cmrmentioning

confidence: 99%

“…[24]. The treatment response as well as the relapse or reactivation of myopericardial autoimmune inflammation can be easily evaluated by using LGE imaging and the exact and comparable numbers of T1 and T2 mapping during patient's follow up, [18]. All in all CMR is able to be an important cardio-protector for patients with autoimmune diseases and mypericardial involvement as it can halt the ongoing inflammation of the heart…”

Section: Treatment For Pericarditis and Cmrmentioning

confidence: 99%

CMR in Pericardial Diseases - an Update

Vidalakis

Kolentinis

Gawor

et al. 2020

Curr Cardiovasc Imaging Rep

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Purpose of Review To review the latest developments and the current role of the cardiac magnetic resonance (CMR) in pericardial diseases and their complications. Recent Findings Cardiac Magnetic Resonance (CMR) has the ability to incorporate anatomy, physiology, and "virtual histology" strategies to achieve the most accurate diagnosis for even the most demanding, pericardial diseases. Summary Acute, chronic, recurrent, and constrictive pericarditis as well as pericarditis related complications, pericardial masses and congenital pericardial defects are commonly encountered in clinical practice with relatively significant morbidity and mortality. Owing to the challenging diagnosis, CMR imaging is often employed in confirming the diagnosis and elucidating the underling pathophysiology. In this review we outline the common CMR techniques and their expected diagnostic outcomes.

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“…It not only improves diagnostic accuracy, but also predicts outcomes with higher T 2 values predicting major cardiovascular events and hospitalization. T 2 mapping is also being explored in other inflammatory diseases including acute cardiac allograft rejection, sarcoidosis, systemic lupus erythematosus, and acute infarction, with the potential of reducing the need for invasive cardiac biopsy in some scenarios. Elevated T 2 mapping values compared with healthy controls have also been demonstrated in subsets of dilated cardiomyopathy and aortic stenosis, potentially enabling disease substratification .…”

Section: Quantitative Tissue Characterization Using Parametric Mappinmentioning

confidence: 99%

Quantitative cardiac MRI

Seraphim

Knott

Augusto

et al. 2019

Magnetic Resonance Imaging

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Cardiac MRI has become an indispensable imaging modality in the investigation of patients with suspected heart disease. It has emerged as the gold standard test for cardiac function, volumes, and mass and allows noninvasive tissue characterization and the assessment of myocardial perfusion. Quantitative MRI already has a key role in the development and incorporation of machine learning in clinical imaging, potentially offering major improvements in both workflow efficiency and diagnostic accuracy. As the clinical applications of a wide range of quantitative cardiac MRI techniques are being explored and validated, we are expanding our capabilities for earlier detection, monitoring, and risk stratification of disease, potentially guiding personalized management decisions in various cardiac disease models. In this article we review established and emerging quantitative techniques, their clinical applications, highlight novel advances, and appraise their clinical diagnostic potential. Level of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:693–711.

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High-sensitive troponin is associated with subclinical imaging biosignature of inflammatory cardiovascular involvement in systemic lupus erythematosus

Abstract: NCT02407197; Results.

Cited by 59 publications

References 57 publications

Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain

Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain

CMR in Pericardial Diseases - an Update

Quantitative cardiac MRI

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