Extended T2-Times in Cardiovascular Magnetic Resonance (CMR) in Patients with Systemic Lupus Erythematosus (SLE) and Persisted Dyspnoea: Is SLE-Associated Myocarditis an Underestimated Problem?

Dr. Philipp Sewerin¹, Vera Lachmann², Mareike Gastl², Patrick Behm³, PD Dr. Rebecca Fischer-Betz⁴, Prof. Dr. Benedikt Ostendorf¹, Dr. Gamal Chehab⁵, Prof. Dr. Matthias Schneider¹, Prof. Dr. Malte Kelm² and Dr. Florian Bönner², ¹Department of Rheumatology & Hiller Research Unit, Heinrich-Heine University, Düsseldorf, Germany, ²Department of Internal Medicine, Division of Cardiology, Pulmology and Vascular Medicine and Molecular Cardiology, Heinrich-Heine University, Düsseldorf, Germany, ³Heinrich-Heine University, Düsseldorf, Germany, ⁴Department of Rheumatology & Hiller Research Unit, Heinrich-Heine-University, Duesseldorf, Germany, ⁵Department of Rheumatology & Hiller Research Unit, Heinrich-Heine University, 40225 Duesseldorf, Germany

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Co-morbidities, MRI, SLE and cardiovascular disease

Session Information

Date: Monday, November 14, 2016

Title: Imaging of Rheumatic Diseases - Poster II: XR/CT/PET/MRI

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: To investigate the value of cardiovascular magnetic resonance (CMR) and T2-mapping in patients with systemic lupus erythematosus (SLE) and persistent dyspnoea without sings for pulmonary involvement (conventional x-rays and pulmonary function testing) as a possible sign for myocardial involvement.

Methods: 5 women fulfilling the ACR criteria for SLE (mean age 47.4 (30-69) years, mean disease duration 10.4 (5.3 – 22) years, with persistent dyspnoea (at least NYHA II) but absence of pathological findings in electrocardiogram (ECG) or echocardiography were investigated by CMR. CMR was conducted with a 1.5 Tesla MRI-System (Achieva, Philips, Best, Netherlands) using a 32-channel coil. T2 mapping was done using a respiration navigator gated Gradient-And Spin-Echo sequence (GRASE, 15 T2 echoes separated by 10ms, res: 1x1x10mm², 3 short axis slices). Images were post-processed using software based on the LabView environment for local T2 value generation (T2 mapping). Strain analysis was conducted entering cine-images into myocardial feature tracking (FTI) analysis software (TomTec Imaging Systems, Unterschleißheim, Germany). A cohort five of age and gender matched volunteers served as controls.

Results: All patients showed significantly extended T2 times as a sign of local inflammation compared with age matched healthy controls (p< 0.05). Moreover, the global systolic longitudinal strain (GLS) as means by systolic function was significantly decreased. In addition, global early diastolic strain rate displayed diastolic dysfunction in comparison to controls.

Conclusion: SLE patients with persistent dyspnoea in absence of pathological findings in ECG and echocardiography showed significantly extended T2-times in MRI as a sign of local fluid content as a part of myocardial inflammation, reduced GLS and diastolic dysfunction, which would be missed by using conventional technics. CMR and T2-mapping is a possible tool for the investigation of a cardiac involvement in SLE patients and should be investigated in clinical studies.

Disclosure: D. P. Sewerin, None; V. Lachmann, None; M. Gastl, None; P. Behm, None; P. D. R. Fischer-Betz, None; P. D. B. Ostendorf, None; D. G. Chehab, None; P. D. M. Schneider, None; P. D. M. Kelm, None; D. F. Bönner, None.

To cite this abstract in AMA style:

Sewerin DP, Lachmann V, Gastl M, Behm P, Fischer-Betz PDR, Ostendorf PDB, Chehab DG, Schneider PDM, Kelm PDM, Bönner DF. Extended T2-Times in Cardiovascular Magnetic Resonance (CMR) in Patients with Systemic Lupus Erythematosus (SLE) and Persisted Dyspnoea: Is SLE-Associated Myocarditis an Underestimated Problem? [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/extended-t2-times-in-cardiovascular-magnetic-resonance-cmr-in-patients-with-systemic-lupus-erythematosus-sle-and-persisted-dyspnoea-is-sle-associated-myocarditis-an-underestimated-problem/. Accessed .

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