CMR feature tracking in cardiac asymptomatic systemic sclerosis: Clinical implications

Area of Science:

• Cardiology
• Rheumatology
• Medical Imaging

Background:

• Systemic sclerosis (SSc) can affect the heart, even in asymptomatic individuals.
• Myocardial deformation abnormalities have been observed sporadically in SSc patients.
• Cardiac magnetic resonance feature tracking (CMR-FT) offers advanced assessment of myocardial function.

Purpose of the Study:

• To investigate myocardial deformation using CMR-FT in cardiac asymptomatic SSc patients.
• To correlate CMR-FT findings with SSc phenotype and autoimmune markers.

Main Methods:

• Fifty-four asymptomatic SSc patients and 21 healthy controls underwent CMR with feature tracking.
• Analysis included left ventricular (LV) and right ventricular (RV) peak systolic strain (radial, circumferential, longitudinal).
• Late gadolinium enhancement (LGE) was assessed for myocardial fibrosis.

Main Results:

• LV ejection fraction was higher in SSc patients versus controls (p=0.01).
• Impaired LV longitudinal strain was associated with RV insertion fibrosis and subendocardial infarction.
• SSc patients exhibited lower RV longitudinal strain and strain rate compared to controls (p<0.001 and p=0.01).

Conclusions:

• CMR-FT identifies subclinical myocardial fibrosis and infarction in asymptomatic SSc patients through impaired LV longitudinal strain.
• RV longitudinal indices are impaired in SSc patients.
• CMR-FT findings did not correlate with SSc phenotype or autoimmune features.