Silent myocarditis in systemic sclerosis detected by cardiovascular magnetic resonance using Lake Louise criteria

Autor: Georgia Karabela, Efthymios Stavropoulos, John Raftakis, Loukia Koutsogeorgopoulou, George Markousis-Mavrogenis, Michel Noutsias, Gikas Katsifis, Genovefa Kolovou, Sophie Mavrogeni, Sotiris C. Plastiras
Rok vydání: 2017
Předmět:
Gadolinium DTPA
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
Contrast Media
030204 cardiovascular system & hematology
Ventricular Function
Left
0302 clinical medicine
Prednisone
Myocardial fibrosis
medicine.diagnostic_test
biology
Middle Aged
Magnetic Resonance Imaging
Myocarditis
C-Reactive Protein
Treatment Outcome
Erythrocyte sedimentation rate
Cardiology
cardiovascular system
Systemic sclerosis
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
Immunosuppressive Agents
medicine.drug
Research Article
Adult
medicine.medical_specialty
Blood Sedimentation
Asymptomatic
03 medical and health sciences
Troponin T
Predictive Value of Tests
Scleroderma
Limited
Internal medicine
medicine
Humans
cardiovascular diseases
Angiology
030203 arthritis & rheumatology
business.industry
Myocardium
C-reactive protein
Magnetic resonance imaging
medicine.disease
Troponin
Fibrosis
lcsh:RC666-701
Asymptomatic Diseases
Scleroderma
Diffuse
biology.protein
Ventricular Function
Right
Cardiovascular magnetic resonance
business
Biomarkers
Zdroj: BMC Cardiovascular Disorders
BMC Cardiovascular Disorders, Vol 17, Iss 1, Pp 1-7 (2017)
ISSN: 1471-2261
Popis: Background Systemic sclerosis (SSc) is an autoimmune disease characterized by microvascular abnormalities, inflammation and fibrosis. We hypothesized that myocarditis may be diagnosed in asymptomatic SSc, undergoing routine cardio-vascular magnetic resonance (CMR) for fibrosis assessment, using the Lake Louise criteria: T2 ratio, early (EGE) and late gadolinium enhanced (LGE) images. Methods Eighty-two asymptomatic SSc, diagnosed according to American College of Rheumatology criteria, aged 43 ± 5 yrs., 62 with diffuse (dSSc) and 20 with localized (lSSc) systemic sclerosis were evaluated by CMR, performed at 1.5 T scanner, according to Lake Louise criteria. Results CMR documented normal biventricular function in all SSc. However, 7/62 (11.2%) with dSSc and 2/20 (10%) with lSSc, had CMR signs of myocarditis according to Lake Louise criteria, without any clinical cardiac symptom. In these 9 patients, T2 ratio, EGE ratio and LGE (positive in all 9 SSc) were 2.8 ± 0.5%, 8 ± 3% and 5 ± 3% of LV mass, respectively. No correlation between CMR and blood inflammatory indices (C-reactive protein and erythrocyte sedimentation rate), cardiac troponin T, disease characteristics or type of SSc was identified. A repeat CMR at 6 months, after treatment with prednisone and azathioprine, showed normalisation of the acute inflammation CMR indices. Conclusions Silent myocarditis may be diagnosed using the Lake Louise paper criteria in SSc patients without cardiac symptoms, has no correlation with blood inflammatory indices, cardiac troponin or disease characteristics. CMR is a promising tool to diagnose silent myocarditis in SSc and monitor the response to immunosuppressive treatment.
Databáze: OpenAIRE
Externí odkaz: