Application of cardiac magnetic resonance imaging in subclinical systemic sclerosis primary heart involvement
10.3760/cma.j.cn112138-20231101-00277
- VernacularTitle:心脏磁共振在系统性硬化症亚临床心脏受累中的应用
- Author:
Zheng ZHAO
1
;
Ya'nan ZHAO
;
Jingyu JIN
;
Jinshui YANG
;
Jian ZHU
;
Tao LI
Author Information
1. 解放军总医院第一医学中心风湿免疫科，北京 100853
- Keywords:
Scleroderma, systemic;
Magnetic resonance imaging;
Myocardial fibrosis
- From:
Chinese Journal of Internal Medicine
2024;63(2):176-182
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:Primary cardiac involvement (SSc-PHI) in systemic sclerosis is an important prognostic factor. We aimed to characterize and identify subclinical SSc-PHI using cardiovascular MRI to determine whether disease severity and serum biomarkers are associated with subclinical SSc-PHI.Methods:A total of 26 patients with SSc who had no history of cardiovascular disease or pulmonary hypertension underwent 3 T-enhanced cardiovascular MRI. Measurements included native T 1, extracellular volume, advanced gadolinium enhancement, T 2 mapping, and left ventricular volume function. Troponin T and N telencephalic natriuretic peptide precursors were also determined. Results:LGE was observed in 13 of 26 patients (50.0%), suggesting focal fibrosis, and T 2 mapping was significantly higher in the dcSSc group than in the lcSSc group ( P=0.009). Left ventricular volume and function were within the normal range in all patients, but final systolic left ventricular volume was significantly higher in dcSSc than in lcSSc ( P=0.021). The modified Rodnan skin score (mRSS) was significantly higher in patients with LGE focal fibrosis ( P=0.019). Logistic regression analysis confirmed the association between mRSS and LGE ( OR=1.224, P=0.037). In multivariate analysis, T 2 mapping was negatively correlated with disease course, and was correlated with dcSSc and fingertip ulcer ( R2=0.711, P=0.018, P=0.013, P=0.030). Troponin T was correlated with T 2 mapping ( r=0.555, P=0.049). Conclusions:Subclinical SSc-PHI is characterized by diffuse and focal myocardial fibrosis, but preserves myocardial systolic function. Subclinical SSC-Phi is associated with TNT, SSc disease severity, and complex peripheral vascular disease. These data provide information for identifying individuals at risk of SSc-PHI.
