Abstract
Background 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 11 women fulfilling the ACR criteria for SLE (mean age 37±14.81 years, mean disease duration 13.75±8.47 years, mean SLEDAI 6.82±3) with persistent dyspnoea (at least NYHA II) but absence of pathological findings in electrocardiogram (ECG), echocardiography and lung function 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 10 ms, res: 1 × 1 × 10 mm², 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 eleven of age and gender matched healthy controls (HC) served as controls.
Results All SLE 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.
Conclusions 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.
