Cardiac Intravoxel Incoherent Motion Diffusion‐Weighted Magnetic Resonance Imaging With T1 Mapping to Assess Myocardial Perfusion and Fibrosis in Systemic Sclerosis: Association With Cardiac Events From a Prospective Cohort Study
- 7 May 2020
- journal article
- research article
- Published by Wiley in Arthritis & Rheumatology
- Vol. 72 (9), 1571-1580
- https://doi.org/10.1002/art.41308
Abstract
Background Myocardial involvement may occur during systemic sclerosis (SSc) and lead to impaired myocardial contraction and/or arrhythmia. Cardiac magnetic resonance imaging (CMRI) is used for noninvasive characterization of myocardium. We aimed to evaluate the interest of CMRI with intravoxel incoherent motion (IVIM) diffusion‐weighted imaging (DWI) and T1 mapping to assess myocardial microvascular and interstitium impairment in SSc. Patients and methods Single‐center prospective study of 40 consecutive patients with SSc. CMRI with IVIM DWI and T1 mapping sequences were performed in all patients on a 3T system. Results T1 values were higher in SSc than in healthy controls, and higher T1 values were associated with diffuse cutaneous SSc (dcSSc), immunological pattern associated with dcSSc forms, higher mRSS and higher frequency of interstitial lung disease. T1 was correlated with mRSS (r=+0.32, P=0.04) and forced vital capacity (r=‐0.34, P=0.048), and tended to be correlated with total lung capacity (r=‐0.30, P=0.07). Lower values of f coefficient, associated with decreased tissue perfusion, were associated with less frequent use of vasodilators and more frequent use of glucocorticoids. f coefficient was inversely correlated with T1 (r=‐0.31, P=0.02). Finally, higher T1 values were associated with cardiac events (log‐rank test for trend P=0.03). Conclusion This study shows the interest of CMRI with T1 mapping sequences and IVIM DWI in SSc to assess myocardial involvement. Increased T1 values, potentially suggesting microscopic fibrosis, was more frequently observed in patients with dcSSc and was associated with interstitial lung disease, and with more frequent cardiac events during follow‐up.This publication has 29 references indexed in Scilit:
- Subclinical myocardial inflammation and diffuse fibrosis are common in systemic sclerosis – a clinical study using myocardial T1-mapping and extracellular volume quantificationJournal of Cardiovascular Magnetic Resonance, 2014
- Five-year follow-up of left ventricular diastolic function in systemic sclerosis patients: Determinants of mortality and disease progressionSeminars in Arthritis and Rheumatism, 2014
- Scleroderma Renal CrisisThe Journal of Rheumatology, 2014
- Identification and Assessment of Anderson-Fabry Disease by Cardiovascular Magnetic Resonance Noncontrast Myocardial T1 MappingCirculation: Cardiovascular Imaging, 2013
- The degree of skin involvement identifies distinct lung disease outcomes and survival in systemic sclerosisAnnals Of The Rheumatic Diseases, 2013
- Prognostic impact of coronary microcirculation abnormalities in systemic sclerosis: a prospective study to evaluate the role of non-invasive testsArthritis Research & Therapy, 2013
- Trends in mortality in patients with systemic sclerosis over 40 years: a systematic review and meta-analysis of cohort studiesRheumatology, 2011
- T2-weighted cardiovascular magnetic resonance in acute cardiac diseaseJournal of Cardiovascular Magnetic Resonance, 2011
- Evaluation of the effect of nifedipine upon myocardial perfusion and contractility using cardiac magnetic resonance imaging and tissue Doppler echocardiography in systemic sclerosisAnnals Of The Rheumatic Diseases, 2005