Azoulay Lévi-Dan, Kachenoura Nadjia, Boussouar Samia, Charpentier Etienne, Giron Alain, Broussaud Thomas, Amoura Zahir, Redheuil Alban
Sorbonne Université, Laboratoire d'Imagerie Biomédicale, Inserm, CNRS, Paris, France.
Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne 2, Centre National de Référence du Lupus, Hôpital Pitié-Salpêtrière, Paris, France.
Eur Radiol. 2024 Dec 19. doi: 10.1007/s00330-024-11282-6.
The aim of this study was to compare CMR imaging biomarkers between SLE patients and matched controls.
Electronic databases were systematically searched from inception until November 2023. All studies reporting CMR imaging data in SLE patients were included. PRISMA guidelines were followed, and risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale. CMR findings of SLE patients were compared to that of matched controls. Clinical features associated with CMR biomarkers were collected in a qualitative analysis.
A total of 64 studies were included in the systematic review pooling 3304 individuals including 1870 SLE patients. Of these, 19 case-control studies were included in the comparative meta-analysis (1576 individuals, including 884 SLE patients). Compared to controls, left ventricular (LV) ejection fraction (62% vs. 64%, p = 0.001) and indexed end-diastolic volume (77 vs. 72 mL/m, p = 0.006) were significantly altered in SLE patients. Late gadolinium enhancement (LGE) extent was higher in SLE patients (LGE mass/total LV mass: 3.5% vs. 1.1%, p = 0.009). Native T1 and T2 relaxation times were significantly higher in SLE patients (native T1 [1.5 T]: 1005 vs. 982 ms, p = 0.02; native T1 [3 T]: 1267 vs. 1140 ms, p < 0.001; T2 [all fields]: 58 vs. 51 ms, p < 0.001). Three studies found an association between disease activity and increased T2 relaxation times. Two studies identified an association between clinical outcomes and CMR parameters.
While CMR-assessed ventricular function and volumes only slightly differed in SLE patients when compared to controls, myocardial tissue characterization parameters were significantly modified and associated with disease activity.
Question What are the diagnostic and prognostic values of cardiac magnetic resonance (CMR) quantitative parameters in systemic lupus erythematosus (SLE) patients? Findings Myocardial tissue characterization parameters are significantly altered in SLE patients and associated with disease activity. Clinical relevance CMR imaging demonstrates subclinical cardiac alterations in systemic lupus erythematosus patients. Additional studies are required to further demonstrate the prognostic value of CMR in SLE.
本研究旨在比较系统性红斑狼疮（SLE）患者与匹配对照者的心脏磁共振成像（CMR）生物标志物。
从数据库建立至2023年11月进行系统检索。纳入所有报告SLE患者CMR成像数据的研究。遵循PRISMA指南，并使用纽卡斯尔 - 渥太华质量评估量表评估偏倚风险。将SLE患者的CMR检查结果与匹配对照者进行比较。在定性分析中收集与CMR生物标志物相关的临床特征。
系统评价共纳入64项研究，汇总3304例个体，其中包括1870例SLE患者。其中，19项病例对照研究纳入比较性荟萃分析（1576例个体，包括884例SLE患者）。与对照组相比，SLE患者的左心室射血分数（62%对64%，p = 0.001）和指数化舒张末期容积（77对72 mL/m，p = 0.006）有显著改变。SLE患者的钆延迟增强（LGE）范围更高（LGE质量/左心室总质量：3.5%对1.1%，p = 0.009）。SLE患者的固有T1和T2弛豫时间显著更高（固有T1[1.5T]：1005对982 ms，p = 0.02；固有T1[3T]：1267对1140 ms，p < 0.001；T2[所有场强]：58对51 ms，p < 0.001）。三项研究发现疾病活动与T2弛豫时间增加之间存在关联。两项研究确定了临床结局与CMR参数之间的关联。
与对照组相比，CMR评估的SLE患者心室功能和容积仅有轻微差异，但心肌组织特征参数有显著改变且与疾病活动相关。
问题 心脏磁共振（CMR）定量参数在系统性红斑狼疮（SLE）患者中的诊断和预后价值是什么？发现 SLE患者的心肌组织特征参数有显著改变且与疾病活动相关。临床意义 CMR成像显示系统性红斑狼疮患者存在亚临床心脏改变。需要进一步研究以进一步证明CMR在SLE中的预后价值。
