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Cardiovascular magnetic resonance reveals myocardial involvement in patients with active stage of inflammatory bowel

Maximilian Fenski1, Endri Abazi1, Jan Gröschel1

  • 1Working Group Cardiovascular Magnetic Resonance, Experimental and Clinical Research CenterMax-Delbrück Center for Molecular MedicineDepartment of Cardiology and Nephrology, Charité Medical Faculty, HELIOS Klinikum Berlin Buch, Charité - Universitätsmedizin Berlin Lindenberger Weg 80, 13125, Berlin, Germany.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|August 5, 2024
PubMed

Insights

Active inflammatory bowel disease (IBD) is linked to heart issues. Cardiovascular magnetic resonance imaging reveals myocardial inflammation and adverse remodeling in active IBD patients, suggesting a direct cardiac impact.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Medical Imaging

Background:

  • Active inflammatory bowel disease (A-IBD) is associated with increased cardiovascular mortality and heart failure hospitalizations, unlike disease in remission (R-IBD).
  • Understanding the cardiac implications of IBD is crucial for patient management and risk stratification.

Purpose of the Study:

  • To investigate adverse myocardial remodeling in IBD patients using cardiovascular magnetic resonance (CMR).
  • To correlate myocardial changes with the activity of inflammatory bowel disease.

Main Methods:

  • Prospective enrollment of 44 IBD patients (26 active, 18 remission) and 44 healthy volunteers (HV).
  • Cardiac phenotyping via CMR, including cine imaging, strain analysis, T1 mapping, extracellular volume, and late-gadolinium enhanced imaging.
  • Assessment of myocardial inflammation using simultaneous T1 and T2 elevation criteria.

Main Results:

  • Active IBD patients exhibited impaired ventricular function (reduced strain) despite preserved ejection fraction.
  • Increased markers of diffuse left ventricular fibrosis were observed in A-IBD patients compared to R-IBD and HV.
  • A significantly higher prevalence of myocardial inflammation was found in A-IBD patients (30.8%) versus R-IBD (0%) and HV (2.3%).
  • Diffuse fibrosis markers correlated with IBD disease activity.

Conclusions:

  • CMR demonstrates myocardial involvement in IBD patients.
  • Evidence of adverse left ventricular remodeling is present in IBD, particularly in active disease stages.
  • Disease activity in IBD correlates with myocardial fibrosis and inflammation.
Abstract

Keywords:
Cardiac remodelingCrohn’s diseaseExtraintestinal manifestationInflammationUlcerative colitis

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