Title:Imaging Patterns of Cardiovascular Involvement in Mixed Connective Tissue Disease Evaluated by Cardiovascular Magnetic Resonance
Volume: 14
Issue: 2
Author(s): Sophie Mavrogeni, Petros P. Sfikakis, Theodoros Dimitroulas, Loukia Koutsogeorgopoulou, Georgia Karabela, Gikas Katsifis, Efthymios Stavropoulos, Elias Gialafos, George Spiliotis, Genovefa Kolovou and George D. Kitas
Affiliation:
Keywords:
Mixed connective tissue diseases, cardiovascular magnetic resonance, ECG, echocardiography.
Abstract: Background: To clarify the imaging patterns of cardiovascular lesions in patients with mixed connective tissue
disease (MCTD) and cardiovascular symptoms with or/ without abnormal routine non-invasive evaluation.
Patients-Methods: Twenty-two MCTD patients (19F/3M), aged 38±4 yrs with cardiovascular symptoms were evaluated
using a 1.5 T scanner. Of them, 8/22 had systemic lupus erythematosus (SLE), 5/22 rheumatoid arthritis (RA), 5/22
scleroderma (SSc) and 4/22 myositis (MY) overlap syndromes; 10/22 patients with MCTD presented with Raynaud
phenomenon (RP) and all were positive for Anti-RNP antibodies. The cardiovascular magnetic resonance study (CMR)
included evaluation of function, inflammation and fibrosis. Myocardial stress perfusion-fibrosis evaluation was performed
only in MCTD patients with RP.
Results: A positive CMR study was identified in 4/8 with SLE, 1/5 with RA, 4/5 with SSc and in 1/4 with MY like
MCTD. The CMR lesions were subendocardial or transmural LGE following the distribution of coronary arteries,
intramyocardial LGE and diffuse subendocardial LGE in SLE-RA, MY and SSc like MCTD, respectively. Although no
evidence of fibrosis was identified in patients with RP, adenosine stress myocardial perfusion revealed diffuse
subendocardial perfusion defects. No correlation between disease duration and/or inflammatory indices and cardiac
lesions was identified.
Conclusion: CMR can reveal myocardial lesions in MCTD patients with cardiac symptoms including myocardial
infarction, inflammation, diffuse subendocardial fibrosis and diffuse perfusion defects, necessitating further cardiac
investigation and/or treatment.
