Meloni Antonella, Gargani Luna, Bruni Cosimo, Cavallaro Camilla, Gobbo Marco, D'Agostino Andreina, D'Angelo Gennaro, Martini Nicola, Grigioni Francesco, Sinagra Gianfranco, De Caterina Raffaele, Quaia Emilio, Mavrogeni Sophie, Cademartiri Filippo, Matucci-Cerinic Marco, Pepe Alessia
Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.
Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
Int J Cardiol. 2023 Apr 1;376:139-146. doi: 10.1016/j.ijcard.2023.01.066. Epub 2023 Jan 31.
We evaluated the prevalence of myocardial involvement by native T1 and T2 mapping, the diagnostic performance of mapping in addition to conventional Lake Louise Criteria (LLC), as well as correlations between mapping findings and clinical or conventional cardiovascular magnetic resonance (CMR) parameters in systemic sclerosis (SSc) patients.
Fifty-five SSc patients (52.31 ± 13.24 years, 81.8% female) and 55 age- and sex-matched healthy subjects underwent clinical, bio-humoral assessment, and CMR. The imaging protocol included: T2-weighted, early post-contrast cine sequences, native T1 and T2 mapping by a segmental approach, and late gadolinium enhancement (LGE) technique.
Global myocardial T1 and T2 values were significantly higher in SSc patients than in healthy subjects. An increase in native T1 and/or T2 was present in the 62.1% of patients with normal conventional CMR techniques (negative LGE and T2-weighted images). Respectively, 13.5% and 59.6% of patients fulfilled original and updated LLC (overall agreement = 53.9%). Compared with patients with normal native T1, patients with increased T1 (40.0%) featured significantly higher left ventricular end-diastolic volume index and cardiac index, biventricular stroke volume indexes, and global heart T2 values, and more frequently had a history of digital ulcers. Biochemical and functional CMR parameters were comparable between patients with normal and increased T2 (61.8%).
T1 and T2 mapping are sensitive parameters that should be included in the routine clinical assessment of SSc patients for detecting early/subclinical myocardial involvement.
我们评估了通过天然T1和T2成像测定的心肌受累患病率、除传统的路易斯湖标准（LLC）外成像的诊断性能，以及系统性硬化症（SSc）患者成像结果与临床或传统心血管磁共振（CMR）参数之间的相关性。
55例SSc患者（年龄52.31±13.24岁，81.8%为女性）和55例年龄及性别匹配的健康受试者接受了临床、生物体液评估及CMR检查。成像方案包括：T2加权成像、造影剂注射后早期电影序列、采用节段性方法的天然T1和T2成像，以及延迟钆增强（LGE）技术。
SSc患者的整体心肌T1和T2值显著高于健康受试者。在传统CMR技术正常（LGE和T2加权图像为阴性）的患者中，62.1%存在天然T1和/或T2升高。分别有13.5%和59.6%的患者符合原始和更新后的LLC（总体一致性=53.9%）。与天然T1正常的患者相比，T1升高的患者（40.0%）的左心室舒张末期容积指数、心脏指数、双心室搏出量指数和整体心脏T2值显著更高，且更常有手指溃疡病史。T2正常和升高的患者之间的生化和功能CMR参数相当（61.8%）。
T1和T2成像是敏感参数，应纳入SSc患者的常规临床评估中，以检测早期/亚临床心肌受累情况。
