Cardiac magnetic resonance in systemic sclerosis patients with cardiac symptoms.

OBJECTIVE: Systemic sclerosis\r\n(SSc) is characterized by widespread vascular\r\nlesions and skin and internal organs fibrosis, including\r\nthe heart; all cardiac layers, endocardium,\r\nmyocardium, and pericardium, may be involved.\r\nWe report the relevance of cardiac MRI\r\nfindings in scleroderma patients with cardiac\r\nsymptoms.\r\nPATIENTS AND METHODS: 50 patients, all fulfilling\r\nthe ACR SSc criteria (19 with limited and\r\n31 with diffused skin involvement) were evaluated\r\nusing a 1.5T MR scanner. Images were acquired\r\nbefore and after contrast medium administration;\r\nthe exams were considered positive\r\nwith one or more of these findings: enlarged volumes,\r\nreduced EF, regional kinetic anomalies,\r\nedema, DE or pericardial effusion.\r\nRESULTS: 40 patients (80%) had one or more\r\ncardiac abnormalities: 5 patients had myocardial\r\nedema; 2 an increased interventricular septum\r\nthickness; 22 dilated ventricles or reduced\r\nEF; 12 an abnormal regional ventricular motion\r\n(2 of these with akinetic segments); 17 a delayed\r\nenhancement with different patterns, all without\r\ncoronary distribution; 22 a pericardial effusion\r\nCONCLUSIONS: Pathologic findings were documented\r\nin 80% of the cases confirming a high\r\noccurrence of abnormal MR data. Myocardial involvement\r\nin systemic sclerosis can be assumed\r\nby the presence of multiple pathologic MRI findings.\r\nCMR seems to be a valuable tool to identify\r\nand assess the presence of cardiac involvement.