Abstract
Background Cardiac involvement in systemic sclerosis (SSc) is mainly characterised by diffuse myocardial fibrosis and impairment of the microcirculation; even if clinically silent, it is increasingly recognized to be responsible for higher morbidity and mortality rate. Cardiovascular magnetic resonance (CMR) is the most accurate non-invasive method able to detect myocardial inflammation and fibrosis, even though traditional CMR techniques such as T2-weighted and late gadolinium enhancement (LGE) are inaccurate to assess diffuse myocardial disease. Our aim was to investigate diffuse cardiac damage and perfusion abnormalities in asymptomatic SSc patients without known cardiac disease, using newer non-invasive imaging technique, such as T1 mapping and extracellular volume fraction (ECV), in pre-clinical stage.
Highlights
Cardiac involvement in systemic sclerosis (SSc) is mainly characterised by diffuse myocardial fibrosis and impairment of the microcirculation; even if clinically silent, it is increasingly recognized to be responsible for higher morbidity and mortality rate
T1 values and extracellular volume fraction (ECV) did not correlate with the presence of late gadolinium enhancement (LGE) but they were associated to higher disease activity and severity
SSc patients with no cardiac symptoms and preserved left ventricular size and function have cardiac involvement, which can be detected with conventional T2 weighted and LGE imaging
Summary
Cardiac involvement in systemic sclerosis (SSc) is mainly characterised by diffuse myocardial fibrosis and impairment of the microcirculation; even if clinically silent, it is increasingly recognized to be responsible for higher morbidity and mortality rate. Cardiovascular magnetic resonance (CMR) is the most accurate non-invasive method able to detect myocardial inflammation and fibrosis, even though traditional CMR techniques such as T2-weighted and late gadolinium enhancement (LGE) are inaccurate to assess diffuse myocardial disease. Our aim was to investigate diffuse cardiac damage and perfusion abnormalities in asymptomatic SSc patients without known cardiac disease, using newer non-invasive imaging technique, such as T1 mapping and extracellular volume fraction (ECV), in pre-clinical stage. Significantly higher in SSc patients compared to controls (1043±37 vs 980±33 p
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