Cardiac magnetic resonance imaging in systemic sclerosis: a cross-sectional observational study of 52 patients.
Cardiac magnetic resonance imaging in systemic sclerosis: a cross-sectional observational study of 52 patients.
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DOI：
10.1136/ard.2008.095836
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发表时间：
2009-12
影响因子：
27.4
通讯作者：
Hachulla E
中科院分区：
文献类型：
--
作者：
Hachulla AL;Launay D;Gaxotte V;de Groote P;Lamblin N;Devos P;Hatron PY;Beregi JP;Hachulla E
目的：评价系统性硬化症(SSC)患者心脏磁共振成像(MRI)检测到的心脏异常的发生率和类型。连续52例SSc患者接受心脏MRI检查，以确定其形态、功能、静息血流灌注和延迟增强异常。52例患者中有39例(75%)至少有一项心脏MRI异常。T2期心肌信号增强6例(12%)，左室心肌变薄15例(29%)，心包积液10例(19%)。左、右室射血分数改变分别为12例(23%)和11例(21%)。43例患者中有15例(35%)存在左室舒张功能不全。LV运动异常16例(31%)，心肌延迟增强11例(21%)。未发现静息状态下的血流灌注缺陷。局限性SSc患者的MRI异常与弥漫性SSc患者相似。40例无肺动脉高压的患者中有7例(17%)出现右室扩张。本研究表明，MRI是诊断SSc心脏受累及其机制，包括炎症、微血管和纤维化成分的一种可靠和敏感的技术。与超声心动图相比，MRI似乎通过可视化心肌纤维化和炎症提供了额外的信息。右室扩张似乎不是肺动脉高压的特异症，但也可以反映与SSC相关的心肌损害。需要进一步的研究来确定心脏MRI异常是否对预后和治疗策略有影响。
To assess the prevalence and patterns of cardiac abnormalities as detected by cardiac magnetic resonance imaging (MRI) in systemic sclerosis (SSc). Fifty-two consecutive patients with SSc underwent cardiac MRI to determine morphological, functional, perfusion at rest and delayed enhancement abnormalities. At least one abnormality on cardiac MRI was observed in 39/52 patients (75%). Increased myocardial signal intensity in T2 was observed in 6 patients (12%), thinning of left ventricle (LV) myocardium in 15 patients (29%) and pericardial effusion in 10 patients (19%). LV and right ventricle (RV) ejection fractions were altered in 12 patients (23%) and 11 patients (21%), respectively. LV diastolic dysfunction was found in 15/43 patients (35%). LV kinetic abnormalities were found in 16/52 patients (31%) and myocardial delayed contrast enhancement was detected in 11/52 patients (21%). No perfusion defects at rest were found. Patients with limited SSc had similar MRI abnormalities to patients with diffuse SSc. Seven of 40 patients (17%) without pulmonary arterial hypertension had RV dilatation. This study shows that MRI is a reliable and sensitive technique for diagnosing heart involvement in SSc and for analysing its mechanisms, including its inflammatory, microvascular and fibrotic components. Compared with echocardiography, MRI appears to provide additional information by visualising myocardial fibrosis and inflammation. RV dilatation appeared to be non-specific for pulmonary arterial hypertension but could also reflect myocardial involvement related to SSc. Further studies are needed to determine whether cardiac MRI abnormalities have an impact on the prognosis and treatment strategy.
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影响因子：
37.8
作者：
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通讯作者：
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作者：
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