2038 CMR detects transient and permanent myocardial injury in Churg-Strauss syndrome
Journal of Cardiovascular Magnetic Resonance
Objective Cardiac magnetic resonance imaging (CMR) has the potential to visualize various forms of transient and permanent myocardial damage in inflammatory diseases. We report on CMR in patients with clinical evidence of myocardial involvement in Churg-Strauss syndrome. In this vasculitis, inflammatory damage of small cardiac vessels can result in myocarditis and cardiomyopathy. Methods We studied 10 patients (7 women, median 44 years) with biopsy-proven Churg-Strauss syndrome and clinical
... me and clinical evidence of cardiac involvement in a 1.5 T clinical scanner. Left ventricular (LV) size and function were measured using ECG-triggered SSFP sequences during breathhold. We quantified myocardial water content with triple-inversion T2-weighted fast spin echo images (TR = 2 RR, TE = 64 ms, slice thickness 20 mm). Early contrast enhancement was measured on T1-weighted fast spin echo images before and early after administration of 0.1 mmol/kg Gadolinium-DTPA (nonbreathhold acquisition over 4 minutes TR = 1 RR, TE = 14 ms, slice thickness 8 mm). After a second contrast dose delayed enhancement images for fibrosis detection were acquired. Myocardial signal intensity was quantified on T2 and T1-weighted images and compared to skeletal muscle as a reference. Values were compared to a large data set from normal volunteers. Elevated myocardial signal in T2 compared to skeletal muscle was considered edema, whereas elevated early myocardial enhancement compared to skeletal muscle was considered positive for inflammation. Patients were followed clinically and in CMR for a median time of 3 years. In total 41 scans were performed.