Purpose
Heart involvement in systemic sclerosis (SSc) affects the prognosis of the disease when it is clinically evident (1).
Cardiac magnetic resonance imaging (MRI) is a recent,
accurate and sensitive method of studying heart structure and function non-invasively (1,
2).
There is an association between severe skin involvement and burden of organ-based complications (3) (Fig.1).The modified Rodnan skin thickness score (MRSS) has been used to evaluate skin involvement in SSc (4).
The aim of our study was to examine the prevalence of late enhancement (LE) in...
Methods and Materials
Patients population
27 patients fulfilling the American College of Rheumatology criteria and/or LeRoy’s classification criteria for the diagnosis of SSc were enrolled in this study. Patient’s MRSSs,
antibody results,
duration of disease since first Raynaud’s phenomenon/non-Raynaud’s phenomenon and cardiac MRI result were evaluated for any connection.
Magnetic Resonans Imaging
LE cardiac MRI performed to all patients.
MRI studies were obtained on a 1.5 T clinical system (Gyroscan Achieva,
Philips,
Best,
Netherlands.
LE cardiac MRI protocol was performed using inversion-recovery-prepared,
ECG gated,
gradient-echo pulse sequence
Statistical...
Results
Myocardial LE was detected in 11 of 27 patients (Fig.2 ).
Tzelepis et al.
(5) reported in their study that in SSc,
myocardial LE was characteristically at midwall,
with a linear pattern in all of the patients and some of the patients also had additional patchy and nodular LE pattern.
In our study,
in six patients linear or strap like LE pattern (Fig.
3) and in five patients focal or nodular LE area (Fig.4) has been detected.
In our study there were some patients who...
Conclusion
This study shows that cardiac involvement has no relation with MRSS and other clinical features in SSc except anti-scl70 antibody.
Even though there is another study (2) that shows no connection between anti-scl-70 antibody and LE,
we have found a meaningful inverse relationship.
To enlighten this inverse relationship further studies with larger series are needed to be performed.
References
1) Hachulla AL,
Launay D,
Gaxotte V,
De Groote P,
Lamblin N,
Devos P,
Hatron PY,
Beregi JP,
Hachulla E.
Cardiac magnetic resonance imaging in systemic sclerosis: a cross-sectional observational study of 52 patients.
Ann Rheum Dis 2009;68:1878–1884.
doi:10.1136/ard.2008.095836.
2) Sano M,
Satoh H,
Suwa K,
Nobuhara M,
Saitoh T,
Saotome M,
Urushida T,
Katoh H,
Shimoyama K,
Suzuki D,
Ogawa N,
Takehara Y,
Sakahara H,
Hayashi H.
Characteristics and clinical relevance of late gadolinium enhancement in cardiac magnetic resonance in patients with systemic sclerosis....