PMID- 24331867 OWN - NLM STAT- MEDLINE DCOM- 20140826 LR - 20220309 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 171 IP - 1 DP - 2014 Jan 15 TI - Cardiovascular magnetic resonance imaging in asymptomatic patients with connective tissue disease and recent onset left bundle branch block. PG - 82-7 LID - S0167-5273(13)02102-5 [pii] LID - 10.1016/j.ijcard.2013.11.059 [doi] AB - BACKGROUND-AIM: Recent LBBB in connective tissue diseases (CTDs) is challenging, due to high incidence of underlying pathology that may remain undetected, due to limitations of imaging tests. We hypothesized that cardiovascular magnetic resonance (CMR) may be of diagnostic value in CTDs with recent LBBB and normal echocardiogram. PATIENTS-METHODS: 26 CTDs, aged 32 +/- 7 yrs (19 F) and 26 controls without CTDs, aged 60 +/- 4 yrs (10 F) with recent LBBB and normal echo were evaluated by CMR. The CTDs included 6 sarcoidosis (SRC), 4 systemic sclerosis (SSc), 6 systemic lupus erythematosus (SLE), 6 rheumatoid arthritis (RA) and 4 inflammatory myopathies (IM). CMR was performed by 1.5T. LVEF, T2 ratio (oedema imaging) and late gadolinium enhancement (LGE) (fibrosis imaging) were evaluated. Acute and chronic lesions were characterised by T2>2 and positive LGE and T2<2 and positive LGE, respectively. According to LGE, lesions were characterised as diffuse subendo-, subepicardial/intramural not following and subendocardial/transmural following the distribution of coronaries, indicative of vasculitis, myocarditis and myocardial infarction, respectively. RESULTS: CTDs were younger (p<0.001), with higher incidence of abnormal CMR (42.31 vs 30.77%, p=NS), including dilated cardiomyopathy (11.54%), diffuse subendocardial fibrosis (11.54%), myocardial infarction (7.69%) and acute myocarditis (11.54%) vs dilated cardiomyopathy (19.23%), myocardial infarction (7.69%) and acute myocarditis (3.85%), detected in non-CTDs. CONCLUSIONS: In CTDs with recent LBBB, CMR documented acute and chronic cardiac pathology, particularly myocarditis. CMR should be considered as an adjunct to conventional diagnostic workup in both patient groups, more so in CTDs. CI - Copyright (c) 2013 Elsevier Ireland Ltd. All rights reserved. FAU - Mavrogeni, Sophie AU - Mavrogeni S AD - Onassis Cardiac Surgery Center, Athens, Greece. Electronic address: soma13@otenet.gr. FAU - Sfikakis, Petros P AU - Sfikakis PP AD - Rheumatology Unit, First Department of Propeudeutic and Internal Medicine, Laikon Hospital, Athens University Medical School, Athens, Greece. FAU - Karabela, Georgia AU - Karabela G AD - Athens Naval Hospital, Athens, Greece. FAU - Stavropoulos, Efthymios AU - Stavropoulos E AD - Athens Naval Hospital, Athens, Greece. FAU - Spiliotis, Georgios AU - Spiliotis G AD - Athens Naval Hospital, Athens, Greece. FAU - Gialafos, Elias AU - Gialafos E AD - Bioiatriki MRI Unit, Athens, Greece. FAU - Panopoulos, Stylianos AU - Panopoulos S AD - Rheumatology Unit, First Department of Propeudeutic and Internal Medicine, Laikon Hospital, Athens University Medical School, Athens, Greece. FAU - Bournia, Vasiliki AU - Bournia V AD - Rheumatology Unit, First Department of Propeudeutic and Internal Medicine, Laikon Hospital, Athens University Medical School, Athens, Greece. FAU - Manolopoulou, Dionisia AU - Manolopoulou D AD - Onassis Cardiac Surgery Center, Athens, Greece. FAU - Kolovou, Genovefa AU - Kolovou G AD - Onassis Cardiac Surgery Center, Athens, Greece. FAU - Kitas, George AU - Kitas G AD - Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester, UK. LA - eng PT - Journal Article DEP - 20131204 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Adult MH - Asymptomatic Diseases/*epidemiology MH - Bundle-Branch Block/*diagnosis/*epidemiology MH - Connective Tissue Diseases/*diagnosis/*epidemiology MH - Female MH - Humans MH - *Magnetic Resonance Imaging, Cine/methods MH - Male MH - Middle Aged MH - Young Adult OTO - NOTNLM OT - Cardiovascular magnetic resonance OT - Connective tissue diseases OT - LBBB OT - Myocardial infarction OT - Myocarditis OT - Vasculitis EDAT- 2013/12/18 06:00 MHDA- 2014/08/27 06:00 CRDT- 2013/12/17 06:00 PHST- 2013/08/14 00:00 [received] PHST- 2013/11/23 00:00 [accepted] PHST- 2013/12/17 06:00 [entrez] PHST- 2013/12/18 06:00 [pubmed] PHST- 2014/08/27 06:00 [medline] AID - S0167-5273(13)02102-5 [pii] AID - 10.1016/j.ijcard.2013.11.059 [doi] PST - ppublish SO - Int J Cardiol. 2014 Jan 15;171(1):82-7. doi: 10.1016/j.ijcard.2013.11.059. Epub 2013 Dec 4.