Correlation between cardiovascular magnetic resonance features and clinical characteristics of cardiac involvement in connective tissue diseases.
10.11817/j.issn.1672-7347.2025.240388
- Author:
Jing LUO
1
,
2
,
3
;
Hui ZHOU
1
;
Yisha LI
4
;
Yangzhen HOU
1
;
Ji YANG
1
;
Tengyu LIUYANG
4
,
5
Author Information
1. Department of Radiology, Xiangya Hospital, Central South University, Changsha
2. 18273916330@
3. com.
4. Department of Rheumatology and Immunology, Xiangya Hospital, Central South University, Changsha
5. ytyliu@csu.edu.cn.
- Publication Type:Journal Article
- Keywords:
cardiovascular magnetic resonance;
connective tissue disease;
high-sensitivity cardiac troponin T;
myocardium;
therapy
- MeSH:
Humans;
Retrospective Studies;
Male;
Female;
Connective Tissue Diseases/blood*;
Middle Aged;
Adult;
Biomarkers/blood*;
Magnetic Resonance Imaging/methods*;
ROC Curve;
Interleukin-6/blood*;
Troponin T/blood*
- From:
Journal of Central South University(Medical Sciences)
2025;50(5):777-792
- CountryChina
- Language:English
-
Abstract:
OBJECTIVES:Patients with connective tissue diseases (CTD) have a high incidence of cardiac involvement, which often presents insidiously and can progress rapidly, making it one of the leading causes of death. Multiparametric cardiovascular magnetic resonance (CMR) provides a comprehensive quantitative evaluation of myocardial injury and is emerging as a valuable tool for detecting cardiac involvement in CTD. This study aims to investigate the correlations between CMR features and serological biomarkers in CTD patients, assess their potential clinical value, and further explore the impact of pre-CMR immunotherapy intensity on CMR-specific parameters, thereby evaluating the role of CMR in the early diagnosis of CTD-related cardiac involvement.
METHODS:A retrospective analysis was conducted on 72 consecutive CTD patients who underwent CMR at Xiangya Hospital of Central South University between September 2019 and March 2024. Clinical data, serological markers, and CMR parameters were collected. Differences in CMR parameters were compared between CTD patients with positive and negative serological markers. Correlations between serological biomarkers and CMR parameters were analyzed, with subgroup analyses performed for different CTD subtypes. Logistic regression (univariate and multivariate) was applied to explore the effects of pre-CMR immunotherapy intensity on CMR parameters, and receiver operating characteristic (ROC) curve analysis was used to determine cutoff values.
RESULTS:In differential analyses, CTD patients with elevated interleukin (IL)-1β and IL-6 levels exhibited significantly higher myocardial T2 values compared with those with normal levels (P=0.014, P=0.012). Elevated IL-10 was associated with a higher prevalence of microvascular lesions on CMR (P=0.038). Correlation analysis revealed a significant positive association between high-sensitivity cardiac troponin T (hs-cTnT) and T2 values (r=0.371, P=0.009). ROC analysis indicated that when the hs-cTnT threshold was 0.01 ng/mL, the sensitivity and specificity for predicting elevated left ventricular T2 values were 85.71% and 61.11%, respectively [area under the curve (AUC)=0.767, P=0.001]. hs-cTnT and creatine kinase (CK) were also positively correlated with native T1 values (r=0.371, P=0.009; r=0.364, P=0.032). Erythrocyte sedimentation rate (ESR) showed a positive correlation with the percentage of the late gadolinium enhancement (LGE) (r=0.236, P=0.047). Conversely, hs-cTnT correlated negatively with global radial strain (GRS) (r=-0.297, P=0.034), while CK correlated negatively with both GRS and global circumferential strain (GCS) (r=-0.292, P=0.022; r=-0.282, P=0.027). Among patients with elevated hs-cTnT, the cumulative glucocorticoid dose prior to CMR was negatively associated with elevated T2 values (OR=0.997, P=0.018), and this correlation remained significant after adjusting for duration of steroid use (OR=0.997, P=0.044). ROC analysis showed that when the cumulative glucocorticoid dose did not exceed 613 mg/mL (prednisone equivalent), the sensitivity and specificity for predicting elevated T2 values were 90.48% and 77.78%, respectively (AUC=0.862, P<0.001).
CONCLUSIONS:Several inflammatory biomarkers demonstrate correlations with specific CMR parameters, with hs-cTnT showing the strongest associations across multiple indices. Elevated hs-cTnT suggests a high likelihood of cardiac involvement in CTD patients. Furthermore, pre-CMR immunotherapy intensity significantly influences the specificity of T2 mapping, indicating its importance in interpreting CMR results. These findings provide critical insights for clinicians in the early recognition, timely intervention, and disease evaluation. Future research should further explore the role of CMR in the assessment of CTD-related cardiac assessment of CTD-related cardiac involvement. Future studies should further explore the role of CMR in evaluating CTD cardiac manifestations and its integration with other clinical data to optimize patient management.
