Native T1 mapping in early diffuse and limited systemic sclerosis, and its association with diastolic function.

Area of Science:

• Cardiovascular Imaging
• Radiology
• Rheumatology

Background:

• Systemic Sclerosis (SSc) is an autoimmune disease characterized by fibrosis, affecting internal organs.
• SSc is classified into diffuse (dcSSc) and limited (lcSSc) subtypes, with dcSSc exhibiting more severe organ damage.
• Early detection of cardiac involvement in SSc is crucial for patient management.

Purpose of the Study:

• To evaluate the utility of cardiovascular magnetic resonance (CMR) parametric mapping in detecting early cardiac involvement in SSc.
• To compare cardiac involvement between the diffuse cutaneous SSc (dcSSc) and limited cutaneous SSc (lcSSc) subtypes using CMR.
• To assess the correlation between CMR findings and clinical parameters in SSc patients.

Main Methods:

• Eighty SSc patients (37 dcSSc, 43 lcSSc) underwent 3.0 Tesla CMR between July 2018 and July 2021.
• Myocardial damage was analyzed using CMR parametric mapping, including native T1, T2, and extracellular volume fraction (ECV).
• CMR findings were correlated with clinical data and transthoracic echocardiography results.

Main Results:

• Left ventricular ejection fraction was preserved in both dcSSc and lcSSc groups.
• DcSSc patients exhibited significantly higher native T1 and ECV values in the mid-ventricular septum compared to lcSSc patients (p < 0.05).
• Native T1 values correlated positively with echocardiographic markers of diastolic dysfunction and were higher in patients with progressive skin lesions.

Conclusions:

• CMR parametric mapping, particularly native T1, is effective in identifying diffuse myocardial changes in early-stage SSc.
• Native T1 is a sensitive parameter for detecting myocardial involvement and is associated with left ventricular diastolic function in SSc.
• CMR parametric mapping can help differentiate the severity of myocardial involvement between dcSSc and lcSSc, aiding in prediction and management.