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Tytuł:
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Cardiovascular magnetic resonance imaging pattern in patients with autoimmune rheumatic diseases and ventricular tachycardia with preserved ejection fraction.
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Autorzy:
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Mavrogeni SI; Onassis Cardiac Surgery Center, Athens, Greece. Electronic address: .
Sfikakis PP; Joint Rheumatology Programme, National and Kapodistrian University of Athens Medical School, Athens, Greece. Electronic address: .
Markousis-Mavrogenis G; Onassis Cardiac Surgery Center, Athens, Greece.
Bournia VK; Joint Rheumatology Programme, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Poulos G; Onassis Cardiac Surgery Center, Athens, Greece.
Koutsogeorgopoulou L; Joint Rheumatology Programme, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Karabela G; Naval Hospital, Athens, Greece. Electronic address: .
Stavropoulos E; Naval Hospital, Athens, Greece.
Katsifis G; Naval Hospital, Athens, Greece.
Boki K; Sismanoglion Hospital, Athens, Greece. Electronic address: .
Vartela V; Onassis Cardiac Surgery Center, Athens, Greece.
Kolovou G; Onassis Cardiac Surgery Center, Athens, Greece. Electronic address: .
Theodorakis G; Onassis Cardiac Surgery Center, Athens, Greece.
Kitas GD; Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester, UK. Electronic address: .
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Źródło:
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International journal of cardiology [Int J Cardiol] 2019 Jun 01; Vol. 284, pp. 105-109. Date of Electronic Publication: 2018 Oct 25.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Amsterdam : Elsevier
Original Publication: Amsterdam : Elsevier/North-Holland Biomedical Press, c1981-
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MeSH Terms:
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Autoimmune Diseases/*diagnosis
Heart Ventricles/*diagnostic imaging
Myocardium/*pathology
Rheumatic Heart Disease/*diagnosis
Stroke Volume/*physiology
Tachycardia, Ventricular/*diagnosis
Autoimmune Diseases/complications ; Autoimmune Diseases/physiopathology ; Electrocardiography ; Female ; Heart Ventricles/physiopathology ; Humans ; Magnetic Resonance Imaging, Cine/methods ; Male ; Middle Aged ; Prognosis ; Reproducibility of Results ; Rheumatic Heart Disease/complications ; Rheumatic Heart Disease/physiopathology ; Tachycardia, Ventricular/etiology ; Tachycardia, Ventricular/physiopathology
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Contributed Indexing:
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Keywords: Autoimmune rheumatic diseases; Cardiovascular magnetic resonance; Implantable defibrillators; Myocardial fibrosis; Myocardial oedema; Ventricular tachycardia
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Entry Date(s):
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Date Created: 20181109 Date Completed: 20200106 Latest Revision: 20200106
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Update Code:
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20240104
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DOI:
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10.1016/j.ijcard.2018.10.067
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PMID:
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30404725
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Background: Ventricular tachycardia/fibrillation (VT/VF) may occur in autoimmune rheumatic diseases (ARDs). We hypothesized that cardiovascular magnetic resonance (CMR) can identify arrhythmogenic substrates in ARD patients.
Patients - Methods: Using a 1.5 T system, we evaluated 61 consecutive patients with various types of ARDs and normal left ventricular ejection fraction (LVEF) on echocardiography. A comparison of patients with recent VT/VF and those that never experienced VT/VF was performed. CMR parameters included left and right ventricular (LV and RV) end-systolic and end-diastolic volumes (ESV and EDV), T2 signal ratio of myocardium over skeletal muscle, early/late gadolinium enhancement (EGE and LGE), T1/T2-mapping and extracellular volume fraction (ECV).
Results: 21 (34%) patients had a history of recent, electrocardiographically identified, VT/VF. No demographic or functional CMR variables differed significantly between groups. The same was the case for T2 signal ratio and EGE/LGE. Median native T1 mapping values were significantly higher in patients with VT/VF compared to those without [1135.0 (1076.0, 1201.0) vs. 1050.0 (1025.0, 1078.0), p < 0.001], as was the case for mean T2 mapping [60.4 (6.6) vs. 55.0 (7.9), p = 0.009] and median ECV values [32.0 (30.0, 32.0) vs. 29.0 (28.0, 31.5), p = 0.001]. After multivariate corrections for age, LVEDV, LVEF, RVEDV, RVEF, T2 signal ratio, EGE and LGE, these remained significant predictors of having experienced VT/VF in the past.
Conclusions: T1/T2-mapping and ECV offer incremental value as identifiers of arrhythmogenic substrates in ARD patients, beyond traditionally used indices. They can thus guide implantable cardiac defibrillator (ICD) implantation in ARD patients presenting with VT/VF and normal LVEF.
(Copyright © 2018 Elsevier B.V. All rights reserved.)
Comment in: Int J Cardiol. 2019 Aug 15;289:150-151. (PMID: 31085081)
