rss
Ann Rheum Dis 2009;68:1878-1884 doi:10.1136/ard.2008.095836
  • Clinical and epidemiological research
  • Extended report

Cardiac magnetic resonance imaging in systemic sclerosis: a cross-sectional observational study of 52 patients

This article has been Unlocked
  1. A-L Hachulla1,
  2. D Launay2,
  3. V Gaxotte1,
  4. P de Groote3,
  5. N Lamblin3,
  6. P Devos4,
  7. P-Y Hatron2,
  8. J-P Beregi1,
  9. E Hachulla2
  1. 1
    Department of Cardiovascular Radiology, Regional University Hospital, Lille 2 University, Lille, France
  2. 2
    Department of Internal Medicine, National Reference Centre for Systemic and Autoimmune Rare Diseases (Scleroderma), Regional University Hospital, Lille 2 University, Lille, France
  3. 3
    Department of Cardiology, Regional University Hospital, Lille 2 University, Lille, France
  4. 4
    Department of Statistics, Regional University Hospital, Lille 2 University, Lille, France
  1. Correspondence to Dr D Launay, Service de Médecine Interne, Hôpital Claude-Huriez, CHRU Lille, rue Michel Polonovski, 59037 Lille Cedex, France; d-launay{at}chru-lille.fr
  • Accepted 18 November 2008
  • Published Online First 3 December 2008

Abstract

Objectives: To assess the prevalence and patterns of cardiac abnormalities as detected by cardiac magnetic resonance imaging (MRI) in systemic sclerosis (SSc).

Methods: Fifty-two consecutive patients with SSc underwent cardiac MRI to determine morphological, functional, perfusion at rest and delayed enhancement abnormalities.

Results: At least one abnormality on cardiac MRI was observed in 39/52 patients (75%). Increased myocardial signal intensity in T2 was observed in 6 patients (12%), thinning of left ventricle (LV) myocardium in 15 patients (29%) and pericardial effusion in 10 patients (19%). LV and right ventricle (RV) ejection fractions were altered in 12 patients (23%) and 11 patients (21%), respectively. LV diastolic dysfunction was found in 15/43 patients (35%). LV kinetic abnormalities were found in 16/52 patients (31%) and myocardial delayed contrast enhancement was detected in 11/52 patients (21%). No perfusion defects at rest were found. Patients with limited SSc had similar MRI abnormalities to patients with diffuse SSc. Seven of 40 patients (17%) without pulmonary arterial hypertension had RV dilatation.

Conclusions: This study shows that MRI is a reliable and sensitive technique for diagnosing heart involvement in SSc and for analysing its mechanisms, including its inflammatory, microvascular and fibrotic components. Compared with echocardiography, MRI appears to provide additional information by visualising myocardial fibrosis and inflammation. RV dilatation appeared to be non-specific for pulmonary arterial hypertension but could also reflect myocardial involvement related to SSc. Further studies are needed to determine whether cardiac MRI abnormalities have an impact on the prognosis and treatment strategy.

Footnotes

  • Competing interests None.

  • Ethics approval The study was approved by the institutional review board and informed consent was obtained from all patients.

  • A-LH and DL contributed equally to this work.

This article has been Unlocked

This Article

  1. Free via Creative Commons: CC
  2. Abstract
  3. Full text
  4. PDF
  5. All versions of this article:
    1. ard.2008.095836v1
    2. 68/12/1878 most recent

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.