Cardiac magnetic resonance imaging with pharmacological stress perfusion and delayed enhancement in asymptomatic patients with systemic sclerosis

Hitomi Kobayashi, Isamu Yokoe, Masaharu Hirano, Tetsuya Nakamura, Yasuo Nakajima, Kevin R. Fontaine, Jon T. Giles, Yasuyuki Kobayashi

Research output: Contribution to journalArticle

Abstract

Objective. To assess cardiac involvement in asymptomatic patients with systemic sclerosis (SSc) by cardiac magnetic resonance imaging (MRI). Methods. Ten asymptomatic patients with SSc (all female; mean age 59.5 ± 9.4 yrs) underwent contrast enhanced cardiac MRI on a 1.5 T MRI device. Adenosine triphosphate was used for stress and rest perfusion to assess perfusion defects due to microvascular impairment or ischemia, and delayed enhanced (DE) imaging was obtained for the assessment of myocardial necrosis and fibrosis. We evaluated the pathophysiological associations of stress perfusion combined with DE imaging with SSc disease severity measures. Results. Stress perfusion defects were seen in 5 out of 9 patients (56%): 4 had nonsegmental subendocardial perfusion defects and one had a segmental subendocardial perfusion defect. Three patients were found to have DE. DE was not observed in any patient without perfusion defect; and among the 5 patients with perfusion defects, 3 (60%) had DE. Two of the 3 had DE in segments not matching the region of nonsegmental perfusion defects. The remaining one had a segmental subendocardial DE matching the region of a segmental perfusion defect. Perfusion defects were seen in 75% of patients with a history of digital ulceration compared to only 20% of those without history of ulceration. Conclusion. Subclinical myocardial involvement, as detected by cardiac MRI, was frequent in asymptomatic patients with SSc. Cardiac MRI may aid in understanding the pathophysiological mechanism of SSc. The Journal of Rheumatology

Original languageEnglish (US)
Pages (from-to)106-112
Number of pages7
JournalJournal of Rheumatology
Volume36
Issue number1
DOIs
StatePublished - Jan 2009

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Systemic Scleroderma
Perfusion
Magnetic Resonance Imaging
Pharmacology
Rheumatology
Fibrosis
Necrosis
Ischemia
Adenosine Triphosphate
Equipment and Supplies

Keywords

  • Asymptomatic patients
  • Cardiac magnetic resonance imaging
  • Delayed enhancement
  • Pharmacological stress perfusion
  • Systemic sclerosis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

Cardiac magnetic resonance imaging with pharmacological stress perfusion and delayed enhancement in asymptomatic patients with systemic sclerosis. / Kobayashi, Hitomi; Yokoe, Isamu; Hirano, Masaharu; Nakamura, Tetsuya; Nakajima, Yasuo; Fontaine, Kevin R.; Giles, Jon T.; Kobayashi, Yasuyuki.

In: Journal of Rheumatology, Vol. 36, No. 1, 01.2009, p. 106-112.

Research output: Contribution to journalArticle

Kobayashi, H, Yokoe, I, Hirano, M, Nakamura, T, Nakajima, Y, Fontaine, KR, Giles, JT & Kobayashi, Y 2009, 'Cardiac magnetic resonance imaging with pharmacological stress perfusion and delayed enhancement in asymptomatic patients with systemic sclerosis', Journal of Rheumatology, vol. 36, no. 1, pp. 106-112. https://doi.org/10.3899/jrheum.080377
Kobayashi, Hitomi ; Yokoe, Isamu ; Hirano, Masaharu ; Nakamura, Tetsuya ; Nakajima, Yasuo ; Fontaine, Kevin R. ; Giles, Jon T. ; Kobayashi, Yasuyuki. / Cardiac magnetic resonance imaging with pharmacological stress perfusion and delayed enhancement in asymptomatic patients with systemic sclerosis. In: Journal of Rheumatology. 2009 ; Vol. 36, No. 1. pp. 106-112.
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AB - Objective. To assess cardiac involvement in asymptomatic patients with systemic sclerosis (SSc) by cardiac magnetic resonance imaging (MRI). Methods. Ten asymptomatic patients with SSc (all female; mean age 59.5 ± 9.4 yrs) underwent contrast enhanced cardiac MRI on a 1.5 T MRI device. Adenosine triphosphate was used for stress and rest perfusion to assess perfusion defects due to microvascular impairment or ischemia, and delayed enhanced (DE) imaging was obtained for the assessment of myocardial necrosis and fibrosis. We evaluated the pathophysiological associations of stress perfusion combined with DE imaging with SSc disease severity measures. Results. Stress perfusion defects were seen in 5 out of 9 patients (56%): 4 had nonsegmental subendocardial perfusion defects and one had a segmental subendocardial perfusion defect. Three patients were found to have DE. DE was not observed in any patient without perfusion defect; and among the 5 patients with perfusion defects, 3 (60%) had DE. Two of the 3 had DE in segments not matching the region of nonsegmental perfusion defects. The remaining one had a segmental subendocardial DE matching the region of a segmental perfusion defect. Perfusion defects were seen in 75% of patients with a history of digital ulceration compared to only 20% of those without history of ulceration. Conclusion. Subclinical myocardial involvement, as detected by cardiac MRI, was frequent in asymptomatic patients with SSc. Cardiac MRI may aid in understanding the pathophysiological mechanism of SSc. The Journal of Rheumatology

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