Bertrand Dunogué1, Benjamin Terrier2, Pascal Cohen2, Julien Marmursztejn3, Paul Legmann4, Luc Mouthon2, Denis Duboc3, Olivier Vignaux4, Loïc Guillevin2. 1. Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France. Electronic address: bertrand.dunogue@cch.aphp.fr. 2. Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France. 3. Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France. 4. Department of Radiology and Cardiovascular Imaging, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France.
Abstract
OBJECTIVE: To determine the diagnostic and prognostic significance of cardiac magnetic resonance imaging (CMRI) in a cohort of patients with eosinophilic granulomatosis with polyangiitis (EGPA). METHODS: We conducted a monocentric retrospective study including 42 EGPA patients who had consecutively undergone CMRI at diagnosis or during follow-up, independently of signs of cardiac involvement. RESULTS: Forty-two patients (male 59.5%, mean age at diagnosis 46.5 years) were included. ANCA was positive in 26.2%, and median EGPA duration before the 1st CMRI screening was 5 months. Seventeen (40.5%) were diagnosed with cardiomyopathy, independently of CMRI findings. CMRI showed myocardial late gadolinium enhancement (LGE) in 82.4% patients with cardiomyopathy vs. 44% without cardiomyopathy (P=0.024). Using LGE as the sole criterion, CMRI sensitivity and specificity for diagnosing cardiomyopathy were 82.4% and 56%, respectively. Among the 15 patients with cardiomyopathy who underwent additional CMRI during follow-up, CMRI-detected cardiac lesions had improved in 7 patients, while those of 8 patients worsened or stabilized despite treatment. These latter patients presented with significantly more cardiac events during follow-up (P=0.026). No differences were found between non-cardiomyopathic patients with or without CMRI anomalies concerning EGPA cardiac manifestations and outcomes. CONCLUSION: The diagnostic significance of myocardial LGE in EGPA patients remains uncertain and should not be the only criterion for cardiomyopathy diagnosis. For patients with no other signs of cardiomyopathy, CMRI-detected anomalies do not seem to adversely affect prognosis or outcome. For patients with cardiomyopathy, CMRI reassessment seems promising in detecting patients with a less favorable cardiac outcome.
OBJECTIVE: To determine the diagnostic and prognostic significance of cardiac magnetic resonance imaging (CMRI) in a cohort of patients with eosinophilic granulomatosis with polyangiitis (EGPA). METHODS: We conducted a monocentric retrospective study including 42 EGPA patients who had consecutively undergone CMRI at diagnosis or during follow-up, independently of signs of cardiac involvement. RESULTS: Forty-two patients (male 59.5%, mean age at diagnosis 46.5 years) were included. ANCA was positive in 26.2%, and median EGPA duration before the 1st CMRI screening was 5 months. Seventeen (40.5%) were diagnosed with cardiomyopathy, independently of CMRI findings. CMRI showed myocardial late gadolinium enhancement (LGE) in 82.4% patients with cardiomyopathy vs. 44% without cardiomyopathy (P=0.024). Using LGE as the sole criterion, CMRI sensitivity and specificity for diagnosing cardiomyopathy were 82.4% and 56%, respectively. Among the 15 patients with cardiomyopathy who underwent additional CMRI during follow-up, CMRI-detected cardiac lesions had improved in 7 patients, while those of 8 patients worsened or stabilized despite treatment. These latter patients presented with significantly more cardiac events during follow-up (P=0.026). No differences were found between non-cardiomyopathicpatients with or without CMRI anomalies concerning EGPA cardiac manifestations and outcomes. CONCLUSION: The diagnostic significance of myocardial LGE in EGPA patients remains uncertain and should not be the only criterion for cardiomyopathy diagnosis. For patients with no other signs of cardiomyopathy, CMRI-detected anomalies do not seem to adversely affect prognosis or outcome. For patients with cardiomyopathy, CMRI reassessment seems promising in detecting patients with a less favorable cardiac outcome.
Authors: Elisabetta Zanatta; Claudia Colombo; Gianpiero D'Amico; Thomas d'Humières; Carlo Dal Lin; Francesco Tona Journal: Int J Mol Sci Date: 2019-11-07 Impact factor: 5.923
Authors: Rashid S Al Umairi; Khalid Al Manei; Fatma Al Lawati; Yaqoob Al Mahrouqi; Farida Al Balushi Journal: Sultan Qaboos Univ Med J Date: 2021-11-25