Native T1 and T2 mapping by CMR in lupus myocarditis: Disease recognition and response to treatment.
Int J Cardiol
; 222: 717-726, 2016 Nov 01.
Article
em En
| MEDLINE
| ID: mdl-27521546
ABSTRACT
BACKGROUND:
Lupus myocarditis is likely more common than recognized clinically due to non-specific symptoms and lack of reliable non-invasive diagnostic tests. We investigated the role of native T1 and T2 in recognition of active myocardial inflammatory involvement in patients with systemic lupus erythematous (SLE).METHODS:
76 patients with clinically suspected lupus myocarditis (14 males, age 44±16years) underwent quantitative tissue characterization with native T1 and T2 mapping. Normotensive healthy subjects taking no medication served as controls (n=46). Follow-up CMR studies were performed in a total of 35 subjects of which 14 patients received intensified anti-inflammatory treatment, as guided by SLE disease activity.RESULTS:
Compared to controls SLE patients had higher inflammatory markers, LV mass, native T1 and T2 values, and reduced longitudinal strain (p<0.01). In patients with a positive troponin test (n=36; 46%), native T1 and T2 were significantly higher (p<0.01) with otherwise similar proportions of diffuse perimyocardial LGE (33%) and pericardial effusion (32%). Sixty-nine patients (83%) had an abnormal native T1, whereas 51 (71%) met diagnostic criteria for acute myocarditis. Follow-up CMRs revealed significantly greater reduction in native T1 and T2 values in patients with intensified anti-inflammatory treatment (p<0.001) with the greatest change observed within the first follow-up period and plateauing thereafter. Native T1 and T2 were significant predictors of treatment response.CONCLUSIONS:
Native T1 and T2 mapping support recognition of lupus myocarditis and reflect the response to anti-inflammatory treatment. Native T1 and T2 mapping may support an effective, noninvasive, radiation- and gadolinium contrast-free screening method for lupus myocarditis.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Imagem Cinética por Ressonância Magnética
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Lúpus Eritematoso Sistêmico
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Anti-Inflamatórios
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Miocardite
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Miocárdio
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article