Noninvasive method could detect subclinical cardiac impairment in SLE patients
medwireNews: Cardiac magnetic resonance imaging (CMRI) could be used to identify subclinical cardiac impairment in patients with systemic lupus erythematosus (SLE), researchers report.
In a study involving two centers in Germany and the UK, Valentina Puntmann (Goethe University Hospital Frankfurt, Germany) and colleagues found that plasma levels of high-sensitivity cardiac troponin T (hs-cTnT) were significantly elevated among 92 patients with SLE and no known cardiac disease compared with 78 matched controls without SLE (21.4 vs 2.2 ng/mL), indicating “a high prevalence of subclinical myocardial injury.”
The team identified a “strong and predicative relationship” between hs-cTnT levels and a number of components of subclinical cardiac impairment measured by CMRI, including myocardial edema (indicated by native T2), interstitial remodeling (indicated by native T1), and ventricular stiffness, among the SLE patients. The strongest association was seen between hs-cTnT levels and myocardial edema, “underscoring the inflammatory interstitial remodelling as the main mechanism of injury.”
There was, however, no relationship between hs-cTnT and markers of cardiac structure and function, which the researchers say “exposes the limited value of [other] methods, such as echocardiography, in detecting early abnormalities or assessment of the subclinical disease.” They also note that CMRI “can unravel myocardial abnormalities that develop beyond the analytical limits of detection [hs-cTnT],” and that unlike troponin, imaging measures “respond rapidly to altered disease dynamics and/or to anti-inflammatory treatment, providing an objective and immediate clinical assessment.”
Puntmann et al conclude in the Annals of the Rheumatic Diseases that “[t]hese findings substantiate the role of [CMRI] in screening of subclinical cardiac involvement.”
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