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Cardiovascular magnetic resonance imaging in asymptomatic patients with connective tissue disease and recent onset

Sophie Mavrogeni1, Petros P Sfikakis2, Georgia Karabela3

  • 1Onassis Cardiac Surgery Center, Athens, Greece.

International Journal of Cardiology
|December 17, 2013
PubMed

Insights

Cardiovascular magnetic resonance (CMR) detects significant cardiac pathology, including myocarditis, in patients with connective tissue diseases (CTDs) and recent left bundle branch block (LBBB). CMR aids diagnosis when echocardiograms are normal.

Area of Science:

  • Cardiology
  • Radiology
  • Rheumatology

Background:

  • Left bundle branch block (LBBB) in connective tissue diseases (CTDs) presents diagnostic challenges due to potential underlying cardiac pathology.
  • Echocardiography may have limitations in detecting subtle cardiac abnormalities in CTD patients with LBBB.

Purpose of the Study:

  • To evaluate the diagnostic value of cardiovascular magnetic resonance (CMR) in CTD patients presenting with recent LBBB and normal echocardiograms.
  • To identify specific cardiac pathologies associated with LBBB in CTDs using CMR.

Main Methods:

  • 26 CTD patients and 26 controls with recent LBBB and normal echocardiograms underwent 1.5T CMR.
  • CMR assessed left ventricular ejection fraction (LVEF), T2 ratio (edema), and late gadolinium enhancement (LGE) (fibrosis).
  • Cardiac lesions were characterized as acute (T2>2, positive LGE) or chronic (T2<2, positive LGE) and by LGE distribution patterns.

Main Results:

  • CTD patients showed a higher incidence of abnormal CMR findings (42.31%) compared to controls (30.77%).
  • Specific pathologies identified in CTDs included dilated cardiomyopathy, diffuse subendocardial fibrosis, myocardial infarction, and acute myocarditis.
  • CMR revealed acute and chronic cardiac lesions, with myocarditis being a prominent finding in CTDs.

Conclusions:

  • CMR is effective in documenting acute and chronic cardiac pathology in CTD patients with recent LBBB.
  • Myocarditis was a particularly noted finding in the CTD group.
  • CMR should be considered an adjunct to conventional diagnostic workup for LBBB, especially in CTD patients.
Abstract

Keywords:
Cardiovascular magnetic resonanceConnective tissue diseasesLBBBMyocardial infarctionMyocarditisVasculitis

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