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Combined brain and heart magnetic resonance imaging in systemic vasculitides: fiction or real need?


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13

 

  1. Onassis Cardiac Surgery Centre, Athens, Greece. soma13@otenet.gr
  2. Arthritis Research UK Epidemiology Unit, Manchester University, UK.
  3. Leiden University Medical Centre, Department of Radiology, Leiden, the Netherlands.
  4. Neurology Department, Mediterraneo Hospital, Athens, Greece.
  5. 4th Department of Internal Medicine, School of Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Greece.
  6. Department of Pathophysiology, Laikon Hospital, Athens, Greece.
  7. Sismanoglion Hospital, Athens, Greece.
  8. Onassis Cardiac Surgery Centre, Athens, Greece.
  9. Onassis Cardiac Surgery Centre, Athens, Greece.
  10. Onassis Cardiac Surgery Centre, Athens, Greece.
  11. Department of Rheumatology and Clinical Immunology, University Medical Centre Groningen, University of Groningen, the Netherlands.
  12. Department of Internal Medicine, Hôpital Cochin, University Paris Descartes, France.
  13. Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory, National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital, Athens, Greece.

CER11064
2018 Vol.36, N°2 ,Suppl.111
PI 0152, PF 0159
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PMID: 29652661 [PubMed]

Received: 24/12/2017
Accepted : 19/02/2018
In Press: 10/04/2018
Published: 18/05/2018

Abstract

Systemic vasculitides (SVs) is a group of diseases characterised by inflammation/necrosis of the blood vessel wall in various organs. Simultaneous brain and heart involvement is a cause of increased morbidity/mortality in SV. We aimed to present evidence of concurrent brain/heart involvement in SV and the role of a combined brain/heart magnetic resonance imaging (MRI) in their risk stratification. Cerebral vasculitis (CV) can be presented as focal deficits, seizures, headache, neuropsychiatric manifestations or cognitive dysfunction and cardiovascular disease (CVD) as myocardial/vascular inflammation, perfusion/function defects and fibrosis. MRI is a non-invasive, non-radiating technique that allows the reliable identification of intraparenchymal brain lesions and the detection of myocardial/vascular inflammation and fibrosis. However, its use in SV is currently hampered by high cost, lack of availability/expertise and lack of awareness among the clinicians. Although there are no clinical data supporting the combined use of brain/heart MRI in asymptomatic SV, it would be called for in cases with clinical suspicion of brain/heart involvement, especially in those at high risk for CVD/stroke such as SLE/APS. Furthermore, it may be of value in SV with multi-organ involvement, cognitive dysfunction or other neuropsychiatric symptoms with concurrent cardiac involvement, presenting as typical or atypical symptoms with normal routine cardiac evaluation, new onset of arrhythmia and/or HF.

Rheumatology Article