Key result
Cardiac MRI detects abnormalities in 61% of granulomatosis with polyangiitis patients, with fewer in early disease.
Why the study?
Specific cardiac involvement in granulomatosis with polyangiitis is probably underestimated since many conditions are subclinical.
What is the prevalence and pattern of cardiac abnormalities detected by cardiac MRI in patients with granulomatosis with polyangiitis?
Observational (n=31)
What is the prevalence and pattern of cardiac abnormalities detected by cardiac MRI in patients with granulomatosis with polyangiitis?
Cardiac MRI frequently detects subclinical cardiac abnormalities, such as late gadolinium enhancement and wall motion abnormalities, in patients with granulomatosis with polyangiitis.
May support cardiac MRI for subclinical GPA evaluation; leaves open whether findings alter management or outcomes.
Objectives: Specific cardiac involvement in granulomatosis with polyangiitis (GPA) is probably underestimated since many of these conditions are subclinical. The objective of this study was to assess the prevalence and patterns of cardiac abnormalities detected by cardiac MRI (CMRI) in patients with GPA. Methods: Thirty-one consecutive patients with newly diagnosed or relapsing GPA underwent CMRI to assess morphological, functional, perfusion at rest and delayed enhancement abnormalities. Results: At least one abnormality was observed on CMRI for 19 of 31 patients (61%). Four patients (13%) had an impaired left ventricle ejection fraction (LVEF). LV regional wall motion abnormalities were found in 11 patients (35%). Late gadolinium enhancement (LGE) was detected in 10 of 31 patients (32%). LGE was mostly nodular ( n = 9). Myocardial early contrast enhancement was detected in 5 of the 31 patients (16%), which was systematically associated with LGE in the same territory. CMRI detected pericarditis in eight patients (26%). GPA with <18 months duration was associated with a higher LVEF ( P = 0.03), fewer CMRI abnormalities ( P = 0.04) and less LV hypokinesia ( P = 0.04) than GPA with a longer duration. Patients with recent-onset GPA had a higher LVEF ( P = 0.01) and less LV hypokinesia ( P = 0.006) than patients experiencing a relapse ( P = 0.02). Conclusion: CMR is an accurate technique for detecting heart involvement in GPA. This unique non-invasive technique may provide information with important clinical implications for the accurate early assessment of cardiac lesions in GPA patients and for detecting cumulative, irreversible damage. It may also have prognostic implications.
No takes yet. Share an insight, caveat, or question.
Pugnet et al. (2017) conducted an observational in granulomatosis with polyangiitis (n=31). Cardiac MRI was evaluated on Prevalence of at least one cardiac abnormality detected by cardiac MRI. Cardiac MRI detected at least one cardiac abnormality in 61% of patients with granulomatosis with polyangiitis, with fewer abnormalities in those with disease duration <18 months (P=0.04).
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: