Is there a place for cardiovascular magnetic resonance conditional devices in systemic inflammatory diseases?

Area of Science:

• Cardiology
• Immunology
• Radiology

Background:

• Systemic inflammatory diseases (SID) frequently involve the heart, leading to rhythm disturbances and sudden cardiac death (SCD).
• Ventricular tachycardia and atrioventricular block are common device-indicated arrhythmias in SID, particularly sarcoidosis, lupus erythematosus, and scleroderma.
• Cardiac magnetic resonance (CMR) is crucial for diagnosing cardiac involvement in SID.

Purpose of the Study:

• To highlight the importance of cardiac magnetic resonance (CMR) in evaluating sudden cardiac death (SCD) and arrhythmias in patients with systemic inflammatory diseases (SID).
• To emphasize the necessity of MRI-conditional devices for safe and effective cardiac imaging in SID patients.

Main Methods:

• Cardiac magnetic resonance (CMR) was utilized to identify arrhythmic substrates and assess cardiac involvement in SID.
• Late gadolinium enhancement (LGE) on CMR was analyzed to evaluate risk for adverse events.
• The study reviewed the utility of CMR in detecting various cardiac conditions within SID.

Main Results:

• CMR identified late gadolinium enhancement (LGE) in 71% of SCD cases, revealing an arrhythmic substrate in 76%.
• The extent of LGE on CMR predicted increased risk for future adverse events during follow-up.
• CMR successfully detected myocarditis, coronary, microvascular, and valvular diseases in SID patients.

Conclusions:

• Cardiac magnetic resonance (CMR) is essential for diagnosing cardiac disease and assessing SCD risk in systemic inflammatory diseases (SID).
• The findings underscore the need for MRI-conditional devices to enable safe and comprehensive cardiac imaging in SID patients.
• A range of MRI-conditional devices are available, ensuring safe scanning protocols for SID patients requiring cardiac imaging.