PMID- 25190071 OWN - NLM STAT- MEDLINE DCOM- 20151006 LR - 20220317 IS - 2047-2412 (Electronic) IS - 2047-2404 (Linking) VI - 16 IP - 1 DP - 2015 Jan TI - Early myocardial and skeletal muscle interstitial remodelling in systemic sclerosis: insights from extracellular volume quantification using cardiovascular magnetic resonance. PG - 74-80 LID - 10.1093/ehjci/jeu167 [doi] AB - AIMS: Systemic sclerosis (SSc) may induce cardiac fibrosis and systo-diastolic dysfunction. Cardiovascular magnetic resonance (CMR) can detect replacement myocardial fibrosis with late gadolinium enhancement (LGE) and interstitial myocardial fibrosis with T1 mapping techniques. The aim of the study was to detect subclinical cardiac involvement with CMR in paucisymptomatic SSc patients with no previous history of myocardial disease, comparing it with skeletal muscle remodelling. METHODS AND RESULTS: Thirty consecutive SSc patients (mean age: 51 +/- 12 years, all women) and 10 healthy controls (mean age: 48 +/- 15 years, all women) underwent clinical, biohumoral assessment, and CMR. Extracellular volume fraction (ECV) was calculated from pre- and post-contrast T1 values in the myocardium and skeletal muscle. Seventeen patients (57%) were asymptomatic, 13 (43%) paucisymptomatic (effort dyspnoea). All patients had normal biventricular volumes and systolic function, while LGE was present in seven patients (23%). Myocardial ECV was significantly increased in patients with SSc (30 +/- 4%) than controls (28 +/- 4%, P = 0.03), as was skeletal muscle ECV (23 +/- 6% vs. 18 +/- 4%, P < 0.01). Myocardial ECV did not differ between patients with and without LGE (P = NS) and showed no significant correlations with clinical data, biventricular volumes, systolic, or diastolic function. Overall, myocardial ECV showed a significant correlation with skeletal muscle ECV (R = 0.58, P < 0.001). CONCLUSION: SSc is associated not only with myocardial replacement fibrosis, as detected by LGE, but also with interstitial remodelling of the myocardium and skeletal muscles, as detected by an increased ECV also in patients with normal biventricular function, with potential diagnostic, prognostic, and therapeutic clinical implications. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author 2014. For permissions please email: journals.permissions@oup.com. FAU - Barison, Andrea AU - Barison A AD - Fondazione Toscana 'Gabriele Monasterio', CNR, Regione Toscana, Pisa, Italy Institute of Life Sciences, Scuola Superiore 'Sant'Anna', Pisa, Italy. FAU - Gargani, Luna AU - Gargani L AD - Clinical Physiology Institute, National Research Council, CNR, Pisa, Italy. FAU - De Marchi, Daniele AU - De Marchi D AD - Fondazione Toscana 'Gabriele Monasterio', CNR, Regione Toscana, Pisa, Italy. FAU - Aquaro, Giovanni Donato AU - Aquaro GD AD - Fondazione Toscana 'Gabriele Monasterio', CNR, Regione Toscana, Pisa, Italy. FAU - Guiducci, Serena AU - Guiducci S AD - Department of Rheumatology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy. FAU - Picano, Eugenio AU - Picano E AD - Clinical Physiology Institute, National Research Council, CNR, Pisa, Italy. FAU - Cerinic, Marco Matucci AU - Cerinic MM AD - Department of Rheumatology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy. FAU - Pingitore, Alessandro AU - Pingitore A AD - Clinical Physiology Institute, National Research Council, CNR, Pisa, Italy pingi@ifc.cnr.it. LA - eng PT - Comparative Study PT - Journal Article DEP - 20140904 PL - England TA - Eur Heart J Cardiovasc Imaging JT - European heart journal. Cardiovascular Imaging JID - 101573788 RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Adult MH - Case-Control Studies MH - Cohort Studies MH - Endomyocardial Fibrosis/diagnosis/etiology/*pathology MH - Female MH - Follow-Up Studies MH - Gadolinium MH - Humans MH - Magnetic Resonance Imaging, Cine/*methods MH - Middle Aged MH - Muscle, Skeletal/pathology MH - Muscular Diseases/etiology/*pathology MH - Prospective Studies MH - *Radiographic Image Enhancement MH - Reference Values MH - Scleroderma, Systemic/complications/diagnosis/*pathology MH - Statistics, Nonparametric MH - Time Factors MH - Ventricular Function, Left/physiology MH - Ventricular Function, Right/physiology MH - Ventricular Remodeling/*physiology OTO - NOTNLM OT - Cardiac T1 mapping OT - Cardiovascular magnetic resonance OT - Late gadolinium enhancement OT - Myocardial fibrosis OT - Systemic sclerosis EDAT- 2014/09/06 06:00 MHDA- 2015/10/07 06:00 CRDT- 2014/09/06 06:00 PHST- 2014/09/06 06:00 [entrez] PHST- 2014/09/06 06:00 [pubmed] PHST- 2015/10/07 06:00 [medline] AID - jeu167 [pii] AID - 10.1093/ehjci/jeu167 [doi] PST - ppublish SO - Eur Heart J Cardiovasc Imaging. 2015 Jan;16(1):74-80. doi: 10.1093/ehjci/jeu167. Epub 2014 Sep 4.