Impact of cardiac magnetic resonance imaging on eosinophilic granulomatosis with polyangiitis outcomes: A long-term retrospective study on 42 patients
| Autor: | Olivier Vignaux, Denis Duboc, Benjamin Terrier, Loïc Guillevin, Luc Mouthon, Pascal Cohen, Julien Marmursztejn, Bertrand Dunogué, Paul Legmann |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Myocardium Immunology Cardiomyopathy Granulomatosis with Polyangiitis Mean age Retrospective cohort study medicine.disease Prognosis Magnetic Resonance Imaging Eosinophils Cardiac magnetic resonance imaging Cohort Eosinophilic medicine Immunology and Allergy Late gadolinium enhancement Humans Radiology Granulomatosis with polyangiitis business Retrospective Studies |
| Zdroj: | Autoimmunity reviews. 14(9) |
| ISSN: | 1873-0183 |
| Popis: | Objective To determine the diagnostic and prognostic significance of cardiac magnetic resonance imaging (CMRI) in a cohort of patients with eosinophilic granulomatosis with polyangiitis (EGPA). Methods We conducted a monocentric retrospective study including 42 EGPA patients who had consecutively undergone CMRI at diagnosis or during follow-up, independently of signs of cardiac involvement. Results Forty-two patients (male 59.5%, mean age at diagnosis 46.5 years) were included. ANCA was positive in 26.2%, and median EGPA duration before the 1st CMRI screening was 5 months. Seventeen (40.5%) were diagnosed with cardiomyopathy, independently of CMRI findings. CMRI showed myocardial late gadolinium enhancement (LGE) in 82.4% patients with cardiomyopathy vs. 44% without cardiomyopathy (P = 0.024). Using LGE as the sole criterion, CMRI sensitivity and specificity for diagnosing cardiomyopathy were 82.4% and 56%, respectively. Among the 15 patients with cardiomyopathy who underwent additional CMRI during follow-up, CMRI-detected cardiac lesions had improved in 7 patients, while those of 8 patients worsened or stabilized despite treatment. These latter patients presented with significantly more cardiac events during follow-up (P = 0.026). No differences were found between non-cardiomyopathic patients with or without CMRI anomalies concerning EGPA cardiac manifestations and outcomes. Conclusion The diagnostic significance of myocardial LGE in EGPA patients remains uncertain and should not be the only criterion for cardiomyopathy diagnosis. For patients with no other signs of cardiomyopathy, CMRI-detected anomalies do not seem to adversely affect prognosis or outcome. For patients with cardiomyopathy, CMRI reassessment seems promising in detecting patients with a less favorable cardiac outcome. |
| Databáze: | OpenAIRE |
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