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Early detection of myocardial involvement by T 1 mapping of cardiac MRI in idiopathic inflammatory myopathy
Author(s) -
Yu Liuyu,
Sun Jianhong,
Sun Jiayu,
Li Jiangbo,
Dong Yang,
Zhou Xiaoyue,
Greiser Andreas,
Han Yuchi,
Zhang Qing,
Xie Qibing,
Chen Yucheng
Publication year - 2018
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25945
Subject(s) - medicine , cardiology , ejection fraction , ventricle , polymyositis , magnetic resonance imaging , steady state free precession imaging , population , nuclear medicine , radiology , heart failure , environmental health
Background Polymyositis (PM) and dermatomyositis (DM) are common types of idiopathic inflammatory myopathy (IIM), wherein patients are prone to adverse cardiovascular events. Purpose To explore the value of cardiac magnetic resonance imaging (MRI) for detecting cardiac involvement in PM/DM patients using a T 1 mapping technique. Study Type Prospective observational study. Population In all, 25 PM/DM patients free of cardiovascular symptoms and preserved ventricular systolic function and 25 healthy volunteers matched for age and sex served as controls. Field Strength/Sequence Cardiac MRI at 3T, including steady‐state free precession (SSFP) cine imaging, late gadolinium enhancement (LGE), and T 1 mapping with modified Look–Locker inversion recovery (MOLLI). Assessment Myocardial native T 1 and extracellular volume (ECV) of the left ventricle as well as the correlations with disease activity were analyzed. Statistical Tests Independent sample's t ‐test, Fisher's exact test, or chi‐square test, Pearson's correlation ( r ) were applied. P ≤ 0.05 was considered significant. Results Left ventricular end‐diastolic/end‐systolic volume index ( P = 0.643, P = 0.325, respectively), mass index ( P = 0.719), and ejection fraction ( P = 0.144) were not significantly different between PM/DM patients and controls. LGE was found in 19% of PM/DM patients and none of the control subjects. PM/DM patients showed significantly higher native T 1 values (1263.7 ± 84.0 msec vs. 1200.6 ± 43.0 msec, P = 0.002) and expanded extracellular volume (ECV) (32.6 ± 3.7% vs. 26.7 ± 2.3%, P < 0.001) compared with control subjects. ECV values in PM/DM patients had a high proportion (60%) over the 95% percentile of normal controls. Meanwhile, there was a significant correlation between native T 1 ( r = 0.710, P = 0.0001) or ECV ( r = 0.508, P = 0.01) and N‐terminal prohormone of brain natriuretic peptide (NT‐proBNP). Data Conclusion T 1 mapping of cardiac MRI is valuable to detect subclinical myocardial involvement in PM/DM patients, and both myocardial native T 1 and ECV could serve as early imaging markers for myocardial impairment in PM/DM. Level of Evidence : 2 Technical Efficacy : Stage 3 J. MAGN. RESON. IMAGING 2018;48:415–422.