4.7 Article

Towards understanding the phenotypes of myocardial involvement in the presence of self-limiting and sustained systemic inflammation: a magnetic resonance imaging study

Journal

RHEUMATOLOGY
Volume 49, Issue 3, Pages 528-535

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/kep426

Keywords

Cardiovascular; Systemic inflammation; Rheumatoid arthritis; Biomarkers; Magnetic resonance imaging

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Funding

  1. Hammersmith Hospitals
  2. Imperial College London

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Objective. To investigate the patterns of myocardial involvement in the presence of self-limiting and sustained systemic inflammation, using MRI. Methods. Ninety-four subjects, with a clinical diagnosis of myocarditis (n = 36), RA (n = 24) and apparently healthy subjects (n = 34, control group), underwent standardized cardiac MRI protocol for the assessment of global and regional morphology and systolic function using balanced steady-state free precession sequences, T2-weighted images and late gadolinium enhancement (LGE) studies. Results. The three groups were well matched for age, gender and cardiovascular risk factors. The RA group showed markedly increased end-diastolic volumes and reduced ejection fraction (P < 0.05). Antero/inferolateral wall thickness was greater in the myocarditis group and reduced in RA, associated with reduced radial and longitudinal thickening (P < 0.01), and markedly raised T2-oedema ratio and global LGE scores (P < 0.05). Conclusions. Our results may signify the phenotypic features of myocardial plasticity and deformation in response to self-limiting and sustained inflammatory injury.

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