Session Title: Imaging of Rheumatic Diseases Poster III: Other Modalities
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
The risk of major cardiovascular (CV) events and the long-term CV outcome in patients with primary Sjögren’s syndrome (pSS) remain unclear. Myocardial disease is typically clinically silent, only manifesting as myocardial dysfunction after an extended preclinical phase. Feature-tracking (FT) cardiac magnetic resonance (CMR) imaging can reliably be used to assess myocardial function in patients with early dysfunction. Left ventricular (LV) global longitudinal peak systolic strain (GLS) is prognostic of adverse cardiovascular outcomes in various patient populations. Global circumferential peak systolic strain (GCS) is a predictor of congestive heart failure. We sought to measure GLS and GCS using FT-CMR in pSS patients without cardiac symptoms. Furthermore, we aimed to evaluate the association of GLS and GCS with pSS status and severity.
pSS patients without cardiac symptoms were enrolled. Patients and with no history and/or clinical findings of systemic or pulmonary hypertension, coronary artery disease, valvular heart disease, atrial fibrillation, diabetes mellitus, or dyslipidemia underwent non-contrast CMR. Disease activity was assessed using the EULAR Sjӧgren’s Syndrome Disease Activity Index (ESSDAI). Minor salivary gland biopsy was documented in 85% of patients. Salivary gland biopsy data were classified using the focus score (FS). All subjects underwent evaluation of LV regional function, as measured by FT-CMR. GLS and GCS were calculated in the 16 segments of the whole LV. Group comparisons were made using the Wilcoxon rank sum test, Fisher’s exact test, and t-test where appropriate.
We compared 52 patients with pSS (100% women; mean age, 53.2±9.6 years). A total of 11 patients (21%) had Raynaud’s phenomenon (RP). The mean of ESSDAI was 2.5±2.6. The GCS in the RP positive group and FS≥2 group decreased more than that in the RP negative group and FS<2 group (p=0.009, p=0.008, respectively). The GCS tended to decrease in the ESSDAI≥4 group compared to the ESSDAI<4 group(p=0.057). Receiver operating characteristic curve analysis showed that GCS reliably detected RP and FS≥2 (area under the curve, 0.75 and 0.72, respectively). GCS in the pSS group was not associated with CV risk factors or other pSS status. GLS in the pSS group was not associated with CV risk factors or pSS status such as RP, FS, ESSDAI.
To our knowledge, this is the first prospective study of LV regional function in pSS and the only study to explore the associations of pSS characteristics with CMR-assessed GCS and GLS. We suggest that RP, FS≥2 and ESSDAI≥4 may predict LV regional dysfunction observed in patients with pSS without cardiac symptoms. We should consider the possibility of subclinical regional function in patients with pSS, even in those with low scores for FS or ESSDAI.
To cite this abstract in AMA style:Nishiwaki A, Ikumi N, Kobayashi H, Kobayashi Y, Yokoe I, Nagasawa Y, Sugiyama K, Nozaki T, Iwata M, Kitamura N, Takei M. Detection of Left Ventricular Regional Function in Primary Sjögren’s Syndrome Patients without Cardiac Symptons, As Assessed By Feature Tracking Cardiac Magnetic Resonance Imaging [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/detection-of-left-ventricular-regional-function-in-primary-sjogrens-syndrome-patients-without-cardiac-symptons-as-assessed-by-feature-tracking-cardiac-magnetic-resonance-imaging/. Accessed January 21, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/detection-of-left-ventricular-regional-function-in-primary-sjogrens-syndrome-patients-without-cardiac-symptons-as-assessed-by-feature-tracking-cardiac-magnetic-resonance-imaging/