Cardiac MRI in Rheumatic Disease

Area of Science:

• Cardiovascular Medicine
• Immunology
• Medical Imaging

Background:

• Immune-mediated systemic inflammatory disorders pose a significant, often unrecognized, risk for cardiovascular disease.
• Early stages may present with constitutional symptoms, with insidious cardiac manifestation later.
• Myocardial involvement requires sensitive detection for timely intervention.

Purpose of the Study:

• To highlight the critical role of multimodality imaging in diagnosing cardiac involvement in immune-mediated inflammatory diseases.
• To emphasize the advanced capabilities of cardiac MRI (CMR) beyond traditional echocardiography.
• To introduce emerging CMR techniques for enhanced cardiovascular assessment.

Main Methods:

• Transthoracic echocardiogram as a first-line imaging modality.
• Cardiac MRI (CMR) for high-fidelity chamber quantification and parametric mapping.
• Investigation of novel techniques: stress CMR, feature tracking CMR, LGE entropy, and 4D flow CMR.

Main Results:

• Cardiac MRI (CMR) offers superior diagnostic potential compared to echocardiography for myocardial assessment.
• Parametric mapping and advanced CMR techniques provide detailed insights into cardiac structure and function.
• Emerging techniques show promise for earlier and more precise detection of inflammatory cardiac involvement.

Conclusions:

• Multimodality imaging, particularly CMR, is essential for detecting myocardial involvement in systemic inflammatory disorders.
• Cardiac MRI (CMR) significantly enhances diagnostic and therapeutic strategies for these patients.
• Novel CMR techniques represent the future of cardiovascular assessment in immune-mediated diseases.