RT Journal Article
SR Electronic
T1 Cardiac Magnetic Resonance Imaging with Pharmacological Stress Perfusion and Delayed Enhancement in Asymptomatic Patients with Systemic Sclerosis
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 106
OP 112
DO 10.3899/jrheum.080377
VO 36
IS 1
A1 HITOMI KOBAYASHI
A1 ISAMU YOKOE
A1 MASAHARU HIRANO
A1 TETSUYA NAKAMURA
A1 YASUO NAKAJIMA
A1 KEVIN R. FONTAINE
A1 JON T. GILES
A1 YASUYUKI KOBAYASHI
YR 2009
UL http://www.jrheum.org/content/36/1/106.abstract
AB Objective. To assess cardiac involvement in asymptomatic patients with systemic sclerosis (SSc) by cardiac magnetic resonance imaging (MRI). Methods. Ten asymptomatic patients with SSc (all female; mean age 59.5 ± 9.4 yrs) underwent contrast enhanced cardiac MRI on a 1.5 T MRI device. Adenosine triphosphate was used for stress and rest perfusion to assess perfusion defects due to microvascular impairment or ischemia, and delayed enhanced (DE) imaging was obtained for the assessment of myocardial necrosis and fibrosis. We evaluated the pathophysiological associations of stress perfusion combined with DE imaging with SSc disease severity measures. Results. Stress perfusion defects were seen in 5 out of 9 patients (56%): 4 had nonsegmental subendocardial perfusion defects and one had a segmental subendocardial perfusion defect. Three patients were found to have DE. DE was not observed in any patient without perfusion defect; and among the 5 patients with perfusion defects, 3 (60%) had DE. Two of the 3 had DE in segments not matching the region of nonsegmental perfusion defects. The remaining one had a segmental subendocardial DE matching the region of a segmental perfusion defect. Perfusion defects were seen in 75% of patients with a history of digital ulceration compared to only 20% of those without history of ulceration. Conclusion. Subclinical myocardial involvement, as detected by cardiac MRI, was frequent in asymptomatic patients with SSc. Cardiac MRI may aid in understanding the pathophysiological mechanism of SSc.