Pattern and distribution of myocardial fibrosis in systemic sclerosis: A delayed enhanced magnetic resonance imaging study

Objective To assess the prevalence and pattern of myocardial fibrosis as detected by delayed enhanced magnetic resonance imaging (DE‐MRI) in patients with systemic sclerosis (SSc), and to evaluate a possible association between myocardial fibrosis and cardiac arrhythmias. Methods Forty‐one patients...

Full description

Saved in:

Bibliographic Details
Published in:	Arthritis and rheumatism Vol. 56; no. 11; pp. 3827 - 3836
Main Authors:	Tzelepis, George E., Kelekis, Nikolaos L., Plastiras, Sotiris C., Mitseas, Panayiotis, Economopoulos, Nikolaos, Kampolis, Christos, Gialafos, Elias J., Moyssakis, Ioannis, Moutsopoulos, Haralampos M.
Format:	Journal Article
Language:	English
Published:	Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-11-2007 Wiley
Subjects:	Aged Arrhythmias, Cardiac - diagnosis Arrhythmias, Cardiac - epidemiology Arrhythmias, Cardiac - pathology Biological and medical sciences Cardiac dysrhythmias Cardiology. Vascular system Cardiomyopathies - epidemiology Cardiomyopathies - pathology Diseases of the osteoarticular system Electrocardiography, Ambulatory Female Fibrosis Gadolinium Heart Humans Magnetic Resonance Imaging - methods Male Medical sciences Middle Aged Myocardium - pathology Prevalence Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Scleroderma, Systemic - epidemiology Scleroderma, Systemic - pathology Heart Doppler ultrasound study Skin disease Prevalence Arrhythmia Cardiovascular disease Autoimmune disease Gadolinium Epidemiology Vascular disease Heart disease Systemic disease Raynaud phenomenon Scleroderma Sonography Human Acrosyndrome Immunopathology Connective tissue disease Nervous system diseases Myocardial fibrosis Echocardiography Rheumatology Nuclear magnetic resonance imaging Left ventricle Diseases of the autonomic nervous system Capillary vessel disease Medical imagery
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Objective To assess the prevalence and pattern of myocardial fibrosis as detected by delayed enhanced magnetic resonance imaging (DE‐MRI) in patients with systemic sclerosis (SSc), and to evaluate a possible association between myocardial fibrosis and cardiac arrhythmias. Methods Forty‐one patients with SSc underwent 24‐hour Holter monitoring, Doppler echocardiography, and DE‐MRI following gadolinium administration. Results Technically acceptable DE‐MRIs were obtained in 36 patients with SSc. Enhancement on DE‐MRI, consistent with myocardial fibrosis, was observed in 24 of these patients (66%), and it was invariably midwall with a linear pattern, mostly involving basal and midcavity segments of the left ventricle. The volume of enhancement (total volume percentage index [TVPI]) did not differ between patients with diffuse SSc and those with limited SSc (mean ± SD 1.46 ± 1.73% versus 1.44 ± 1.77%; P = 0.98). Patients with a long duration (≥15 years) of Raynaud's phenomenon had a greater number of enhancing segments (mean ± SD 6.55 ± 4.93 versus 2.96 ± 3.46; P = 0.017) and a greater TVPI (mean ± SD 2.44 ± 1.97% versus 1.02 ± 1.43%; P = 0.02) than those with a duration of Raynaud's phenomenon <15 years. Nineteen patients with SSc (53%) had abnormal Holter study results. Compared with patients with normal Holter study results, those with abnormal results had a greater number of enhancing segments (mean ± SD 5.4 ± 4.8 versus 2.5 ± 2.9; P < 0.05) and a greater TVPI (mean ± SD 2.1 ± 1.9% versus 0.8 ± 1.2%; P < 0.05). Conclusion DE‐MRI can identify myocardial fibrosis in a significant percentage of patients with SSc and may be a useful noninvasive tool for determining cardiac involvement.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0004-3591 1529-0131
DOI:	10.1002/art.22971