CMR T 1 mapping and strain analysis in idiopathic inflammatory myopathy: evaluation in patients with negative late gadol
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CMR T1 mapping and strain analysis in idiopathic inflammatory myopathy: evaluation in patients with negative late gadolinium enhancement and preserved ejection fraction Peijun Zhao 1 & Lu Huang 1 & Lingping Ran 1 & Dazhong Tang 1 & Xiaoyue Zhou 2 & Liming Xia 1 Received: 18 March 2020 / Revised: 2 July 2020 / Accepted: 19 August 2020 # European Society of Radiology 2020
Abstract Objectives To investigate whether cardiovascular magnetic resonance (CMR) T1 mapping and strain parameters can detect early histological and functional myocardial changes in idiopathic inflammatory myopathy (IIM) with negative late gadolinium enhancement (LGE) and preserved ejection fraction. Methods Thirty consecutive patients with IIM (41.5 ± 15.4 years, 24 females) who did not have LGE or reduced left ventricular ejection fraction (LVEF) and 30 age- and gender-matched healthy controls (40.6 ± 14.2 years, 20 females) were recruited. Patients with IIM were further classified into two subgroups according to high-sensitivity cardiac troponin I (hs-cTnI) values: elevated hs-cTnI subgroup (n = 10) and normal hs-cTnI subgroup (n = 20). Myocardial native T1 values, extracellular volume (ECV) fractions, and strain parameters were analyzed in patients with IIM and healthy controls. Results Compared with healthy controls, patients with IIM had significantly prolonged native T1 values and increased ECV in each LV segment (p < 0.05). In further subgroup analysis, LV mid-slice native T1 values had the most power to discriminate between patients with elevated hs-cTnI and healthy controls (area under the curve = 0.92). There was no significant difference of global LV strain or strain rates between IIM patients and controls. Conclusions Diffuse interstitial fibrosis can be detected by CMR T1 mapping in patients with IIM who do not have LGE or reduced LVEF or elevated hs-cTnI, and it may be a promising method for screening subclinical cardiac involvement in IIM. Key Points • Myocardial abnormality in IIM is often subclinical and leads to poor prognosis. • Conventional CMR parameters have limitations in early detection of cardiac function and tissue changes. • CMR T1 mapping techniques and myocardial strain analysis have the potential to provide detailed information on cardiac histology and function. Keywords Idiopathic inflammatory myopathy . Myocardium . Fibrosis . Magnetic resonance imaging
Abbreviations BSA Body surface area CK Creatine kinase CK-MB Creatine kinase-MB isoenzymes
* Liming Xia [email protected]; [email protected] 1
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan 430030, People’s Republic of China
2
MR Collaboration, Siemens Healthineers Ltd., Shanghai, People’s Republic of China
CMR CRP DM EDVI EF ESVI Hct HR hs-cTnI IIM LV LVEF NAM NSM
Cardiovascular magnetic resonance C-reactive protein Dermatomyositis End-diastolic volume index Ejection fraction End-systolic volume index Hematocrit Heart rate High-
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