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Diffuse myocardial fibrosis is associated with impaired myocardial strain and disease activity in rheumatoid arthritis: a cardiovascular magnetic resonance study

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Rheumatoid arthritis (RA) is a chronic autoimmune disease of the joints, with frequent extra-articular complications including cardiovascular disease and cardiac fibrosis from multiple causes... Diffuse myocardial fibrosis can be detected non-invasively by extracellular volume (ECV) mapping based on pre- and postcontrast T1 measurements using cardiovascular magnetic resonance (CMR)... We therefore hypothesized that CMR T1 mapping can detect subclinical diffuse myocardial fibrosis in patients with RA. 39 RA patients (28 female, mean age 50 ± 12 years) and 39 matched controls (28 female, mean age 49 ± 12 years) without previously known cardiovascular disease underwent CMR at 1.5T... CMR assessments included late gadolinium enhancement (LGE) [IV gadoterate meglumine at 0.15 mmol/kg], T1 mapping, cine, tagging, and T2-weighted imaging... Focal fibrosis on LGE was found in 18 (46%) RA patients compared to none of controls... There was no difference in left ventricular volumes, mass and ejection fraction between RA patients and controls... However, there were differences in regional function: peak systolic circumferential strain (-16.9 ± 1.3 vs. -18.7 ± 1.2, p < 0.001) and peak diastolic strain rate (83 ± 21 vs. 112 ± 20 s-1, p < 0.001) were impaired in RA patients... Indices of diffuse myocardial fibrosis correlated with impaired myocardial systolic strain, diastolic strain rate and RA disease activity... There was no evidence of myocardial edema in RA... Cardiac involvement is common in RA patients with no cardiovascular symptoms, and includes both focal and diffuse myocardial fibrosis, which is associated with impaired systolic and diastolic strain parameters, as well RA disease activity.

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Diffuse myocardial fibrosis is associated with impaired myocardial strain and disease activity in rheumatoid arthritis: a cardiovascular magnetic resonance study
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4042505&req=5

View Article: PubMed Central - HTML

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Rheumatoid arthritis (RA) is a chronic autoimmune disease of the joints, with frequent extra-articular complications including cardiovascular disease and cardiac fibrosis from multiple causes... Diffuse myocardial fibrosis can be detected non-invasively by extracellular volume (ECV) mapping based on pre- and postcontrast T1 measurements using cardiovascular magnetic resonance (CMR)... We therefore hypothesized that CMR T1 mapping can detect subclinical diffuse myocardial fibrosis in patients with RA. 39 RA patients (28 female, mean age 50 ± 12 years) and 39 matched controls (28 female, mean age 49 ± 12 years) without previously known cardiovascular disease underwent CMR at 1.5T... CMR assessments included late gadolinium enhancement (LGE) [IV gadoterate meglumine at 0.15 mmol/kg], T1 mapping, cine, tagging, and T2-weighted imaging... Focal fibrosis on LGE was found in 18 (46%) RA patients compared to none of controls... There was no difference in left ventricular volumes, mass and ejection fraction between RA patients and controls... However, there were differences in regional function: peak systolic circumferential strain (-16.9 ± 1.3 vs. -18.7 ± 1.2, p < 0.001) and peak diastolic strain rate (83 ± 21 vs. 112 ± 20 s-1, p < 0.001) were impaired in RA patients... Indices of diffuse myocardial fibrosis correlated with impaired myocardial systolic strain, diastolic strain rate and RA disease activity... There was no evidence of myocardial edema in RA... Cardiac involvement is common in RA patients with no cardiovascular symptoms, and includes both focal and diffuse myocardial fibrosis, which is associated with impaired systolic and diastolic strain parameters, as well RA disease activity.

No MeSH data available.