Pseudo-infarction pattern in diffuse systemic sclerosis. Evaluation using cardiovascular magnetic resonance

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• 作者：Sophie Mavrogeni^a ; ^{soma13@otenet.gr" class="auth_mail" title="E-mail the corresponding author} ; Georgia Karabela^b ; Loukia Koutsogeorgopoulou^c ; Efthymios Stavropoulos^b ; Gikas Katsifis^b ; Sotiris C. Plastiras^c ; George D. Kitas^d ; Stylianos Panopoulos^e ; George Pentazos^e ; Eleni Tzatzaki^a ; George Markousis-Mavrogenis^a ; Genovefa Kolovou^a ; Petros P. Sfikakis^e
• 关键词：Scleroderma ; ECG ; Cardiovascular magnetic resonance ; Myocardial fibrosis
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 July 2016
• 年：2016
• 卷：214
• 期：Complete
• 页码：465-468
• 全文大小：450 K

文摘

Diffuse systemic sclerosis (dSSc) is characterized by vascular lesions and fibrosis. Cardiac involvement, although silent, accounts for 36% of deaths. We hypothesized that cardiovascular magnetic resonance (CMR) can clarify the pathophysiology of Q waves in dSSc patients.

Patients–methods

105 dSSc, aged 48 ± 2 years, with atypical symptoms and normal routine assessment, were evaluated by ECG and CMR using a 1.5 T system. Biventricular function was assessed by steady-state free-precession sequence (SSFP). To identify fibrosis, late gadolinium enhanced areas (LGE) were evaluated 15 min after injection of 0.2 mmol/kg gadolinium-DTPA and expressed as % of LV mass.

Results

Q waves in V1–V5 (Group A), II, III, AVF (Group B) and I, AVL, II, III, AVF, V1–V5 (Group C) were found in 25/105, 8/105 and 5/105 dSSc, respectively. In 25 dSSc with Q in V1–V6, patchy intramyocardial LGE was detected in 24/25 and involved 8 ± 2% of LV mass. LGE involved the intraventricular septum (IVS) in 11/24 and the lateral wall (LAT) in 5/24 dSSc. Only in 1/25 dSSc, an anterior, transmural LGE, due to LAD occlusion, was identified. In 8 dSSc with Q in II, III, AVF, patchy intramyocardial LGE was detected in the inferior wall and involved 5 ± 2% of LV mass. In 5 dSSc with Q in V1–V5, II, III, AVF, patchy intramyocardial LGE was detected in anterior and inferolateral wall and involved 9 ± 2% of LV mass.

Conclusion

CMR unveiled that the pattern of myocardial fibrosis in dSSc with Q waves is due to the systemic disease and not to CAD.