PMID- 25890584
OWN - NLM
STAT- MEDLINE
DCOM- 20160201
LR  - 20220330
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 8
IP  - 5
DP  - 2015 May
TI  - Diffuse Myocardial Fibrosis and Inflammation in Rheumatoid Arthritis: Insights 
      From CMR T1 Mapping.
PG  - 526-536
LID - S1936-878X(15)00128-X [pii]
LID - 10.1016/j.jcmg.2014.12.025 [doi]
AB  - OBJECTIVES: The goal of this study was to assess the diffuse myocardial fibrosis 
      and edema in rheumatoid arthritis (RA) using multiparametric cardiac magnetic 
      resonance (CMR) and the association of myocardial T1 and extracellular volume 
      (ECV) with disease activity, duration, and cardiac function. BACKGROUND: RA is a 
      connective tissue disorder, with frequent cardiovascular disease. Myocardial 
      inflammation and diffuse fibrosis can be detected noninvasively by using native 
      T1 mapping and ECV quantification on CMR. METHODS: Thirty-nine RA patients (28 
      women; mean age 50 +/- 12 years) and 39 matched control subjects (28 women; mean 
      age 49 +/- 12 years) underwent CMR at 1.5-T, including cine, tagging, T2-weighted, 
      native T1 mapping (shortened modified Look-Locker inversion recovery), late 
      gadolinium enhancement (LGE), and ECV imaging. RESULTS: Focal fibrosis on LGE was 
      found in 46% of RA patients compared with none of the control subjects. Patients 
      with RA had larger areas of focal myocardial edema (10% vs. 0%), higher native T1 
      values (973 +/- 27 ms vs. 961 +/- 18 ms; p = 0.03), larger areas of involvement as 
      detected by native T1 >990 ms (35% vs. 2%; p < 0.001), and expansion of ECV (30.3 
      +/- 3.4% vs. 27.9 +/- 2.0%; p < 0.001) compared with control subjects. Left 
      ventricular volumes, mass, and ejection fraction were similar between RA patients 
      and control subjects. Peak systolic circumferential strain (-16.9 +/- 1.3 vs. -18.7 
      +/- 1.2; p < 0.001) and peak diastolic circumferential strain rate (83 +/- 21 s(-1) 
      vs. 112 +/- 20 s(-1); p < 0.001) were impaired in RA patients. Myocardial T1 and 
      ECV were correlated with myocardial strain and RA disease activity. CONCLUSIONS: 
      Subclinical cardiovascular disease is frequent in RA, including focal and diffuse 
      myocardial fibrosis and inflammation, which are associated with impaired strain 
      and RA disease activity. CMR T1 mapping provides potential added value as a 
      biomarker for disease monitoring and study of therapies aimed at reducing diffuse 
      myocardial fibrosis in RA.
CI  - Copyright (c) 2015 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Ntusi, Ntobeko A B
AU  - Ntusi NAB
AD  - University of Oxford Centre for Clinical Magnetic Resonance Research, Division of 
      Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe 
      Hospital, Oxford, United Kingdom; Division of Cardiology, Department of Medicine, 
      Groote Schuur Hospital, Cape Town, South Africa.
FAU - Piechnik, Stefan K
AU  - Piechnik SK
AD  - University of Oxford Centre for Clinical Magnetic Resonance Research, Division of 
      Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe 
      Hospital, Oxford, United Kingdom.
FAU - Francis, Jane M
AU  - Francis JM
AD  - University of Oxford Centre for Clinical Magnetic Resonance Research, Division of 
      Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe 
      Hospital, Oxford, United Kingdom.
FAU - Ferreira, Vanessa M
AU  - Ferreira VM
AD  - University of Oxford Centre for Clinical Magnetic Resonance Research, Division of 
      Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe 
      Hospital, Oxford, United Kingdom.
FAU - Matthews, Paul M
AU  - Matthews PM
AD  - GlaxoSmithKline Clinical Imaging Centre, London, United Kingdom; Division of 
      Brain Sciences, Department of Medicine, Imperial College, London, United Kingdom.
FAU - Robson, Matthew D
AU  - Robson MD
AD  - University of Oxford Centre for Clinical Magnetic Resonance Research, Division of 
      Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe 
      Hospital, Oxford, United Kingdom.
FAU - Wordsworth, Paul B
AU  - Wordsworth PB
AD  - Botnar Institute, Nuffield Department of Orthopaedics, Rheumatology and 
      Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre and 
      John Radcliffe Hospital, Oxford, United Kingdom.
FAU - Neubauer, Stefan
AU  - Neubauer S
AD  - University of Oxford Centre for Clinical Magnetic Resonance Research, Division of 
      Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe 
      Hospital, Oxford, United Kingdom.
FAU - Karamitsos, Theodoros D
AU  - Karamitsos TD
AD  - University of Oxford Centre for Clinical Magnetic Resonance Research, Division of 
      Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe 
      Hospital, Oxford, United Kingdom; 1st Department of Cardiology, AHEPA Hospital, 
      Aristotle University, Thessaloniki, Greece. Electronic address: 
      theo.karamitsos@cardiov.ox.ac.uk.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20150415
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - 0 (Contrast Media)
RN  - 0 (Organometallic Compounds)
RN  - 6HG8UB2MUY (Meglumine)
RN  - L0ND3981AG (gadoterate meglumine)
SB  - IM
CIN - JACC Cardiovasc Imaging. 2015 May;8(5):537-9. PMID: 25937192
MH  - Adult
MH  - Arthritis, Rheumatoid/*complications/diagnosis
MH  - Biomechanical Phenomena
MH  - Cardiomyopathies/etiology/*pathology/physiopathology
MH  - Contrast Media
MH  - Edema, Cardiac/etiology/*pathology/physiopathology
MH  - England
MH  - Female
MH  - Fibrosis
MH  - Humans
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Meglumine
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - Myocarditis/etiology/*pathology/physiopathology
MH  - Myocardium/*pathology
MH  - Organometallic Compounds
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Stroke Volume
MH  - Ventricular Function, Left
MH  - Ventricular Function, Right
OTO - NOTNLM
OT  - T1 time
OT  - diffuse myocardial fibrosis
OT  - edema
OT  - extracellular volume estimation
OT  - gadolinium
OT  - inflammation
OT  - inflammatory arthropathies
EDAT- 2015/04/22 06:00
MHDA- 2016/02/02 06:00
CRDT- 2015/04/20 06:00
PHST- 2014/07/24 00:00 [received]
PHST- 2014/12/15 00:00 [revised]
PHST- 2014/12/17 00:00 [accepted]
PHST- 2015/04/20 06:00 [entrez]
PHST- 2015/04/22 06:00 [pubmed]
PHST- 2016/02/02 06:00 [medline]
AID - S1936-878X(15)00128-X [pii]
AID - 10.1016/j.jcmg.2014.12.025 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2015 May;8(5):526-536. doi: 10.1016/j.jcmg.2014.12.025. 
      Epub 2015 Apr 15.