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Clinical Use of Cardiac Magnetic Resonance in Systemic Heart Disease
Sophie Mavrogeni1, George Markousis-Mavrogenis1, Genovefa Kolovou1
1Onassis Cardiac Surgery Center, Athens, Greece.
Insights
Systemic diseases often cause silent heart problems. Cardiovascular magnetic resonance (CMR) effectively detects and monitors cardiac involvement in these conditions, aiding early diagnosis and management.
Area of Science:
- Cardiology
- Rheumatology
- Systemic Diseases
Background:
- Systemic diseases affect multiple organs and the body as a whole, including endocrine, metabolic, nutritional, multisystem (rheumatic), and HIV diseases.
- Cardiovascular involvement is a frequent yet underestimated complication of systemic diseases, manifesting at diagnosis or later.
- Cardiac involvement is often asymptomatic or mildly symptomatic, involving mechanisms like myocardial inflammation, infarction, vasculitis, valvular disease, and fibrosis.
Purpose of the Study:
- To highlight the challenges in diagnosing cardiac involvement in systemic diseases.
- To emphasize the utility of Cardiovascular Magnetic Resonance (CMR) in assessing cardiac complications.
- To establish CMR as a key tool for early diagnosis, risk stratification, and follow-up of cardiac disease in systemic illnesses.
Main Methods:
- Review of pathophysiological mechanisms of cardiac involvement in systemic diseases.
- Discussion of diagnostic challenges, including non-specific signs and patient-specific limitations.
- Evaluation of Cardiovascular Magnetic Resonance (CMR) capabilities for assessing cardiac anatomy, function, inflammation, perfusion, fibrosis, and tissue composition.
Main Results:
- Cardiac involvement in systemic diseases presents diverse pathophysiological mechanisms.
- Diagnostic acuity is often underestimated due to non-specific cardiac signs and patient factors.
- CMR reliably assesses various cardiac parameters, including anatomy, function, inflammation, stress perfusion, fibrosis, and iron/fat deposition.
Conclusions:
- Cardiovascular magnetic resonance (CMR) is an excellent tool for the early diagnosis of heart involvement in systemic diseases.
- CMR facilitates risk stratification, treatment evaluation, and long-term follow-up of patients with systemic diseases and cardiac complications.
- The comprehensive assessment capabilities of CMR are crucial for managing the often-silent cardiac manifestations of systemic illnesses.
Abstract:
A systemic disease is one that affects a number of organs and tissues, or the body as a whole. Systemic diseases include endocrine, metabolic, nutritional, multisystem (rheumatic) and HIV disease. Cardiovascular involvement is a common and underestimated problem in systemic diseases, and may present with disease associated cardiac involvement at diagnosis or later in the course of the systemic disease. The cardiac involvement in these diseases is usually silent or oligo-symptomatic and includes different pathophysiological mechanisms such as, myocardial inflammation, infarction, diffuse, subendocardial vasculitis, valvular disease and different patterns of fibrosis. Furthermore, acuity of heart involvement may be underestimated due to non-specific cardiac signs, and finally, most of patients are female and unable to exercise, due to arthritis or muscular discomfort/weakness or may have limited acoustic window, due to increased breast size. Cardiovascular magnetic resonance (CMR), due to its ability to reliably assess cardiac anatomy, function, inflammation, stress perfusion-fibrosis, aortic distensibility, and iron and fat deposition, constitutes an excellent tool for early diagnosis of heart involvement, risk stratification, treatment evaluation and long-term follow-up of patients with cardiac disease due to systemic diseases.
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