Advanced chronic rheumatic heart disease is associated with substantial myocardial and valvular fibrosis on cardiovascular magnetic resonance

Résumé

Abstract Rheumatic heart disease (RHD) is a major public health concern, particularly in low- and middle-income countries, with a reported 33.4 million cases globally and 319,400 annual deaths. Cardiovascular magnetic resonance (CMR) is a reliable non-invasive technique that detects fibrosis and inflammation in cardiovascular diseases. We assessed myocardial tissue characteristics in chronic RHD using multiparametric CMR. Forty-seven (47) patients with severe, advanced RHD booked for valve replacement surgery, diagnosed on echocardiography, and matched with thirty healthy controls, were scanned using a 3T Siemens Magnetom Skyra. Baseline demographic and clinical characteristics, CMR findings including late gadolinium enhancement (LGE), T1 mapping and ECV measurements were reported. Mean age of patients was 42 ± 12.8 years; 62% (39 ± 12.1 years) female. LGE CMR detected focal myocardial fibrosis in 100% of RHD patients vs. 7% of controls (p < 0.001). In all RHD patients, LGE involving all segments was observed. Patterns of LGE were linear (26%), patchy (36%) and diffuse (38%). We also report elevated mean native T1 (p < 0.004) and ECV (p < 0.001) in all RHD patients compared to controls, respectively. Myocardial fibrosis is abundant in patients with severe, chronic RHD. CMR can be utilised for non-invasive diagnosis of fibrosis and for tracking of disease progression.

Citer ce document

Accès au document

Texte intégral en lecture en ligne, réservé aux abonnés SPHAERO et aux membres de l'institution. Se connecter

Auteur(s)

Statistiques

Consultations : 1

Téléchargements : 0