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Cardiovascular magnetic resonance in the diagnosis and management of cardiac and vascular involvement in the systemic vasculitides

Mavrogeni, Sophie I.a; Dimitroulas, Theodorosb; Kitas, George D.c

Current Opinion in Rheumatology: January 2019 - Volume 31 - Issue 1 - p 16–24
doi: 10.1097/BOR.0000000000000560
VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici

Purpose of review Cardiac manifestations in systemic vasculitides, either primary or secondary due to infection, malignancy or autoimmune rheumatic diseases may be life-threatening. Cardiovascular (CVD) magnetic resonance (CMR) has been recently proposed as an ideal noninvasive tool to evaluate systemic vasculitides. In the present article, we present an overview of CMR in the diagnosis and follow-up of cardiac involvement in systemic vasculitides.

Recent findings CMR is a noninvasive, nonradiating modality, capable to assess cardiac function, perfusion and tissue characterization that can be of great diagnostic value in both primary and secondary systemic vasculitides. It has been already documented that CMR is superior to other imaging modalities, because it has great versatility and higher spatial resolution that allows the detection of early CVD phenomena occurring during systemic vasculitides. Magnetic resonance angiography and oedema-fibrosis imaging detect early CVD involvement such as acute and/or chronic inflammation, coronary macro-micro-circulation abnormalities and/or small vessel vasculitis.

Summary CMR due to its great versatility gives valuable information about cardiac function, perfusion, type of fibrosis and vascular integrity that may significantly contribute to treatment decisions beyond vascular scores, other disease activity or severity indices or the acute phase response.

aOnassis Cardiac Surgery Center, Athens

bAristotle University of Thessaloniki, Thessaloniki, Greece

cArthritis Research UK Centre for Epidemiology, Manchester University, Manchester, UK

Correspondence to Sophie I. Mavrogeni, MD, FESC, Onassis Cardiac Surgery Center, 50 Esperou Street, 175-61 P. Faliro, Athens, Greece. Tel: +30 210 98 82 797; fax: +30 210 98 82 797; e-mail: soma13@otenet.gr

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