Left ventricular myocardial strain analysis by feature tracking cardiac magnetic resonance in patients with...

Cardiovascular involvement is a major contributor to morbidity and mortality in autoimmune rheumatic diseases (ARDs). Subclinical myocardial dysfunction may occur despite preserved conventional cardiac function. Cardiac magnetic resonance feature tracking (CMR-FT) enables sensitive assessment of myocardial deformation and may aid in early detection of cardiac involvement.

To evaluate left ventricular myocardial strain using CMR-FT in patients with ARDs for detection of subclinical myocardial dysfunction.

This case-control study included 30 patients with ARDs and 10 age- and sex-matched healthy controls at Department of Radiology, Ain Shams University Hospitals. All participants underwent cardiac magnetic resonance imaging using standard cine balanced steady-state free precession sequences. Feature-tracking analysis was performed to assess global longitudinal strain (GLS), global circumferential strain (GCS), and strain rate parameters. Strain values were compared between patients and controls, and correlations with disease duration and activity markers were analyzed.

Left ventricular ejection fraction was preserved in both groups, although slightly lower in ARDs patients compared with controls (58.73% ± 5.01 vs. 61.8% ± 2.3). Patients with ARDs demonstrated significantly impaired myocardial deformation, with lower GLS (-17.51% vs. -21.07%, p = 0.001) and GCS (-18.72% vs. -23.27%, p = 0.001) compared with controls. Significant reductions were also observed in circumferential and longitudinal strain rate parameters. No late gadolinium enhancement was detected in the studied patients. Both GLS and GCS showed significant associations with disease duration and inflammatory activity indices. Similar findings were observed in systemic lupus erythematosus and rheumatoid arthritis subgroups.

Patients with autoimmune rheumatic diseases exhibit subclinical left ventricular dysfunction despite preserved ejection fraction and absence of myocardial fibrosis on late gadolinium enhancement imaging. CMR feature tracking represents a sensitive and noninvasive imaging technique for early identification of myocardial involvement in ARDs.