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Myocardial T1 mapping by cardiac magnetic resonance imaging shows early myocardial changes in treatment-naive patients with active rheumatoid arthritis and positive autoantibodies
J.A. Federico1, S.A. Syväranta2, S.S. Tuohinen3, M.M. Holmström4, R.L. Peltomaa5, R.P. Koivuniemi6, M.H. Kestilä7, T.T. Kaasalainen8, J.I. Peltonen9, M.T. Leirisalo-Repo10, S.M. Kivistö11, S.M. Vaara12
- Department of Radiology, Helsinki University Hospital and University of Helsinki, Finland. johanna.federico@hus.fi
- Department of Radiology, Helsinki University Hospital and University of Helsinki, Finland.
- Department of Cardiology, Helsinki University Hospital and University of Helsinki, Finland.
- Department of Radiology, Helsinki University Hospital and University of Helsinki, Finland.
- Department of Rheumatology, Helsinki University Hospital and University of Helsinki, Finland.
- Department of Rheumatology, Helsinki University Hospital and University of Helsinki, Finland.
- Department of Rheumatology, Helsinki University Hospital and University of Helsinki, Finland.
- Department of Radiology, Helsinki University Hospital and University of Helsinki, Finland.
- Department of Radiology, Helsinki University Hospital and University of Helsinki, Finland.
- Department of Rheumatology, Helsinki University Hospital and University of Helsinki, Finland.
- Department of Radiology, Helsinki University Hospital and University of Helsinki, Finland.
- Department of Radiology, Helsinki University Hospital and University of Helsinki, Finland.
CER17094
2024 Vol.42, N°7
PI 1368, PF 1376
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PMID: 38372717 [PubMed]
Received: 29/08/2023
Accepted : 04/12/2023
In Press: 06/02/2024
Published: 18/07/2024
Abstract
OBJECTIVES:
We aimed to study whether myocardial changes are already detectable by cardiac magnetic resonance (CMR) imaging at the time of rheumatoid arthritis (RA) diagnosis.
METHODS:
This single-centre prospective study included 39 treatment-naive patients with early rheumatoid arthritis (ERA, symptom duration <1 year) without any history of heart disease, and 38 age- and sex-matched healthy volunteers. The disease severity was assessed with clinical evaluation (Disease Activity Score-28 for Rheumatoid Arthritis with CRP (DAS28-CRP) score) and serological testing (rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA)). The ERA patients were classified into group A (DAS28-CRP score ≥3.2, positive RF and ACPA; n=17) and group B (not fulfilling the group A criteria). The ERA patients and healthy controls underwent 1.5T CMR.
RESULTS:
Group A patients had significantly higher myocardial global T1 relaxation times than the healthy controls, 987 [965, 1003] ms vs. 979 [960, 991] ms (median [IQR]; p=0.041). A significant difference in T1 was found in the basal, mid inferior and mid anterolateral segments. In a multivariate analysis, prolonged global T1 relaxation time was independently associated with female sex (95% CI [5.62, 51.31] ms, p=0.016), and group A status (95% CI [4.65, 39.01] ms p=0.014).
CONCLUSIONS:
At the time of diagnosis, ERA patients with a higher disease activity (DAS28-CRP score ≥3.2) and both positive RF and ACPA showed prolonged T1 relaxation times in basal myocardial segments. These segments could be most susceptible to the development of myocardial fibrosis, and a segmental reporting style could be useful when estimating the first signs of myocardial fibrosis.
