The role of MRI in cardiovascular involvement of connective tissue diseases

Congress:

ECR 2020

Poster Number:

C-08450

Type:

Educational Exhibit

Keywords:

Cardiac, Cardiovascular system, MR, Diagnostic procedure, Connective tissue disorders, Not applicable

Authors:

A. Banišauskaitė¹, P. Simkus¹, J. Noreikaite², M. Arzanauskaite²; ¹Kaunas/LT, ²Liverpool/UK

DOI:

10.26044/ecr2020/C-08450

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-08450

Fig. 1: The most common CTDs affecting the cardiovascular system.

Table 1: Cardiovascular involvement in other connective tissue diseases and autoimmune...

Table 2: Clinical manifestations, laboratory and imaging findings of systemic sclerosis

Fig. 2: Cardiac MRI study. Panel A – steady-state free precession (SSFP) images in...

Learning objectives

To review cardiovascular manifestations of CTDs. To discuss the diagnostic possibilities of CMR in detecting signs of cardiovascular involvement in CTDs.

Background

Autoimmune connective tissue diseases (CTDs) are a heterogeneous group of disorders that can affect multiple organ systems, including cardiovascular. Despite considerable improvement in treatment and diagnosis of CTDs, high cardiovascular morbidity and premature mortality remains a serious issue, since often cardiovascular manifestations clinically start silently. The identification of underlying cardiovascular disease in patients with CTDs is also difficult due to relapsing nature of CTDs and superimposed acute lesions by pre-existing areas of fibrosis. Echocardiography is the most commonly used non-invasive modality for evaluating cardiovascular involvement...

Findings and procedure details

Systemic sclerosis (SSC) A chronic autoimmune disease, characterized by excessive fibrosis of the skin, internal organs and microangiopathy leading to organ dysfunction. SSC can be diffuse or limited to cutaneous; in some cases disease manifests only in lungs without skin involvement. Clinical manifestations, laboratory and imaging findings of SSC are provided in the table (Table 2). Cardiac manifestations of SCC include myocardial inflammation, fibrosis (Fig.2, Fig.3) and pulmonary hypertension. Rheumatoid arthritis (RA) An autoimmune systemic disorder, which can affect extra-skeletal system, especially heart and lungs,...

Conclusion

Cardiovascular involvement in patients with CTD is common, although, it may clinically start silently. Knowledge of CMR findings and techniques can aid to timely detect various cardiovascular manifestations caused by CTDs and thus improve patients’ quality of life and prognosis.

Personal information and conflict of interest

A. Banišauskaitė; Kaunas/LT - nothing to disclose P. Simkus; Kaunas/LT - nothing to disclose J. Noreikaite; Liverpool/UK - nothing to disclose M. Arzanauskaite; Liverpool/UK - nothing to disclose

References

1.Khanna D, Seibold J, Goldin J, et al. Interstitial lung disease points to consider for clinical trials in systemic sclerosis. Rheumatology (Oxford). 2017;56(suppl_5):v27-v32. 2.Assayag D, Elicker BM, Urbania TH, et al. Rheumatoid arthritis-associated interstitial lung disease: radiologic identification of usual interstitial pneumonia pattern. Radiology. 2014;270(2):583-8. 3.Benjamin C, Carlo Alberto S, Rosaria T, et al. van Vollenhoven R F Mixed connective tissue disease: state of the art on clinical practice guidelines.RMD Open.2018 Oct;4(Suppl 1):e000783. 4.Tani C, Carli L, Vagnani S, et al.The diagnosis and classification of...