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Cardiovascular magnetic resonance in systemic sclerosis: "Pearls and pitfalls"

Sophie I Mavrogeni1, Juerg Schwitter2, Luna Gargani3

  • 1Cardiology Department, Onassis Cardiac Surgery Center, 50 Esperou St, 175-61, P. Faliro, Athens, Greece.

Seminars in Arthritis and Rheumatism
|May 20, 2017
PubMed

Insights

Systemic sclerosis (SSc) heart issues are often hidden. Cardiovascular magnetic resonance (CMR) detects early cardiac inflammation and fibrosis in SSc patients, but requires expert interpretation due to potential image artifacts.

Area of Science:

  • Cardiology
  • Rheumatology
  • Medical Imaging

Background:

  • Systemic sclerosis (SSc) is an autoimmune disease impacting organs, notably the heart, with high but often subclinical prevalence.
  • Cardiac involvement in SSc can be primary (myocardial inflammation/fibrosis) or secondary to pulmonary or systemic hypertension.
  • Early detection of cardiac issues in SSc is crucial for patient management.

Purpose of the Study:

  • To highlight the utility of Cardiovascular Magnetic Resonance (CMR) in the early assessment of cardiac involvement in Systemic Sclerosis.
  • To emphasize CMR's role in detecting myocardial inflammation, fibrosis, and perfusion defects.
  • To address the challenges and expertise required for CMR in SSc patients.

Main Methods:

  • Utilizing Cardiovascular Magnetic Resonance (CMR) as a primary imaging modality.
  • Assessing ventricular volumes, ejection fraction, and myocardial characteristics non-invasively.
  • Analyzing CMR for signs of inflammation, perfusion defects, and fibrosis.

Main Results:

  • CMR is effective in detecting subclinical cardiac involvement in Systemic Sclerosis.
  • CMR reliably identifies myocardial inflammation, perfusion deficits, and fibrosis.
  • Image acquisition and interpretation in SSc patients can be challenging due to artifacts.

Conclusions:

  • Cardiovascular Magnetic Resonance is a valuable tool for early cardiac assessment in Systemic Sclerosis.
  • Expertise in CMR is essential for accurate diagnosis and management of cardiac SSc.
  • Addressing artifacts is key to optimizing CMR utility in SSc.

Keywords:
Cardiac catheterizationCardiovascular magnetic resonance imagingECGEchocardiographySystemic sclerosis

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