TY - JOUR
T1 - Pharmacological stress, rest perfusion and delayed enhancement cardiac magnetic resonance identifies very early cardiac involvement in systemic sclerosis patients of recent onset
AU - Guggino, Giuliana
AU - Ciccia, Francesco
AU - Triolo, Giovanni
AU - Liakouli, Vasiliki
AU - Carubbi, Francesco
AU - Di Benedetto, Paola
AU - Ruscitti, Piero
AU - Di Sibio, Alessandra
AU - Gennarelli, Antonio
AU - Berardicurti, Onorina
AU - Radchenko, Ganna
AU - Splendiani, Alessandra
AU - Masciocchi, Carlo
AU - Di Cesare, Ernesto
AU - Giacomelli, Roberto
AU - Cipriani, Paola
PY - 2017
Y1 - 2017
N2 - Objective: To evaluate occult cardiac involvement in asymptomatic systemic sclerosis (SSc) patients by pharmacological stress, rest perfusion and delayed enhancement cardiac magnetic resonance (CMR), for a very early identification of patients at higher risk of cardiac-related mortality. Methods: Sixteen consecutive patients with definite SSc, fulfilling the American College of Rheumatology/European League Against Rheumatism 2013 classification criteria in less than 1 year from the onset of Raynaud's phenomenon, underwent pharmacological stress, rest perfusion and delayed enhancement CMR. At enrollment, no patient showed signs and/or symptoms suggestive for cardiac involvement. No patient showed traditional cardiovascular risk factors. Both the 12-lead electrocardiogram examination and echocardiographic evaluation did not show any alterations in our cohort. Results: Stress perfusion defects of left ventricle were detected in six out of 16 (37.5%) patients and these defects did not match with the coronary flow distribution. The results showed the presence of two different patterns of stress perfusion defects: sub-endocardial and/or a midmyocardial. The presence of stress perfusion defects did not correlate with any clinical feature of enrolled patients. Conclusion: Myocardial stress perfusion defects may be detected early by pharmacological stress perfusion CMR, a reliable and sensitive technique for the noninvasive evaluation of SSc heart disease, in patients with SSc of recent onset. These defects seem to be independent from traditional risk factors and associated comorbidities, suggesting they are a specific hallmark of the disease.
AB - Objective: To evaluate occult cardiac involvement in asymptomatic systemic sclerosis (SSc) patients by pharmacological stress, rest perfusion and delayed enhancement cardiac magnetic resonance (CMR), for a very early identification of patients at higher risk of cardiac-related mortality. Methods: Sixteen consecutive patients with definite SSc, fulfilling the American College of Rheumatology/European League Against Rheumatism 2013 classification criteria in less than 1 year from the onset of Raynaud's phenomenon, underwent pharmacological stress, rest perfusion and delayed enhancement CMR. At enrollment, no patient showed signs and/or symptoms suggestive for cardiac involvement. No patient showed traditional cardiovascular risk factors. Both the 12-lead electrocardiogram examination and echocardiographic evaluation did not show any alterations in our cohort. Results: Stress perfusion defects of left ventricle were detected in six out of 16 (37.5%) patients and these defects did not match with the coronary flow distribution. The results showed the presence of two different patterns of stress perfusion defects: sub-endocardial and/or a midmyocardial. The presence of stress perfusion defects did not correlate with any clinical feature of enrolled patients. Conclusion: Myocardial stress perfusion defects may be detected early by pharmacological stress perfusion CMR, a reliable and sensitive technique for the noninvasive evaluation of SSc heart disease, in patients with SSc of recent onset. These defects seem to be independent from traditional risk factors and associated comorbidities, suggesting they are a specific hallmark of the disease.
KW - Rheumatology
KW - cardiac magnetic resonance imaging with pharmacological stress
KW - myocardial perfusion defect
KW - systemic sclerosis
KW - systemic sclerosis heart involvement
KW - Rheumatology
KW - cardiac magnetic resonance imaging with pharmacological stress
KW - myocardial perfusion defect
KW - systemic sclerosis
KW - systemic sclerosis heart involvement
UR - http://hdl.handle.net/10447/245722
UR - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1756-185X
M3 - Article
VL - 20
SP - 1247
EP - 1260
JO - International Journal of Rheumatic Diseases
JF - International Journal of Rheumatic Diseases
SN - 1756-1841
ER -