Hromadka Milan, Baxa Jan, Seidlerova Jitka, Miklik Roman, Rajdl Dan, Sudova Vendula, Suchy David, Rokyta Richard
Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen and Faculty Hospital, Charles University, Alej Svobody 80, 304 60 Pilsen, Czech Republic.
Department of Imaging Methods, University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60 Pilsen, Czech Republic.
J Clin Med. 2021 Nov 18;10(22):5364. doi: 10.3390/jcm10225364.
Cardiac involvement in systemic sclerosis (SSc) patients affects mortality. Cardiac magnetic resonance (CMR) is capable of detecting structural changes, including diffuse myocardial fibrosis that may develop over time. Our aim was to evaluate myocardial structure and function changes using CMR in patients with SSc without known cardiac disease during a 5-year follow-up and find possible correlations with selected biomarkers.
A total of 25 patients underwent baseline and follow-up CMR examinations according to a pre-specified protocol. Standard biochemistry, five biomarkers (hsTnI, NT-proBNP, galectin-3, sST2, and GDF-15), and disease-specific functional parameters enabling the classification of disease severity were also measured.
After five years, no patient suffered from manifest heart disease. Mean extracellular volume (ECV) and T1 mapping values did not change significantly ( ≥ 0.073). However, individual increases in native T1 time and ECV correlated with increased galectin-3 serum levels (r = 0.56; = 0.0050, and r = 0.71; = 0.0001, respectively). The progression of skin involvement assessed using the Rodnan skin score and a decrease in the diffusing capacity of the lungs were associated with increased GDF-15 values (r = 0.63; = 0.0009, and r = -0.51; = 0.011, respectively).
During the 5-year follow-up, there was no new onset of heart disease observed in patients with SSc. However, in some patients, CMR detected progression of sub-clinical myocardial fibrosis that significantly correlated with elevated galectin-3 levels. GDF-15 values were found to be associated with disease severity progression.
系统性硬化症（SSc）患者的心脏受累会影响死亡率。心脏磁共振成像（CMR）能够检测结构变化，包括随时间推移可能出现的弥漫性心肌纤维化。我们的目的是在5年随访期间，使用CMR评估无已知心脏病的SSc患者的心肌结构和功能变化，并找出与选定生物标志物的可能相关性。
共有25名患者按照预先指定的方案接受了基线和随访CMR检查。还测量了标准生化指标、五种生物标志物（高敏肌钙蛋白I、N末端脑钠肽前体、半乳糖凝集素-3、可溶性ST2和生长分化因子15）以及能够对疾病严重程度进行分类的疾病特异性功能参数。
五年后，没有患者患明显心脏病。平均细胞外容积（ECV）和T1映射值没有显著变化（≥0.073）。然而，个体的固有T1时间和ECV增加与半乳糖凝集素-3血清水平升高相关（分别为r = 0.56；P = 0.0050，以及r = 0.71；P = 0.0001）。使用罗德南皮肤评分评估的皮肤受累进展以及肺弥散能力下降与生长分化因子15值升高相关（分别为r = 0.63；P = 0.0009，以及r = -0.51；P = 0.011）。
在5年随访期间，SSc患者未观察到新的心脏病发作。然而，在一些患者中，CMR检测到亚临床心肌纤维化进展，这与半乳糖凝集素-3水平升高显著相关。发现生长分化因子15值与疾病严重程度进展相关。
