Event Title

Effect of Systemic Sclerosis on Myocardial Function, Fibrosis, and Blood Flow Measured by Stress Perfusion Cardiovascular Magnetic Resonance Imaging

Advisor(s)

Daniel C. Lee, MD; Northwestern University, Feinberg School of Medicine

Brandon Benefield, MS; Northwestern University, Feinberg School of Medicine

Discipline

Medical and Health Sciences

Start Date

21-4-2021 11:55 AM

End Date

21-4-2021 12:20 PM

Abstract

Systemic sclerosis (SSc) is a disease that causes multisystem fibrosis and has a 10-year survival of 50-84%. Death is 5-15 times more likely when the heart is affected. Myocardial fibrosis in SSc may interfere with heart muscle contraction, relaxation, and microvascular function, resulting in heart failure, ischemia, and arrhythmias. We sought to quantify the effects of SSc on the heart using cardiac magnetic resonance imaging (CMR). In 11 SSc patients and 11 patients with normal clinical stress perfusion CMR, we measured myocardial perfusion reserve (MPR, ratio of blood flow at stress versus rest), extracellular volume fraction (ECV, a measure of myocardial fibrosis), and left ventricular ejection fraction (LVEF, a measure of systolic function). Transmural analysis was done to analyze subendocardial perfusion. ECV was significantly higher (29.3±3.7% vs. 23.6±2.8%, p<0.001), the subendocardial MPR (1.5±0.6 vs. 2.6±1.6, p=0.06) and subepicardial MPR (1.7±0.7 vs. 2.9±1.7, p=0.05) trended towards being significant, and the whole heart MPR (1.6±0.6 vs. 2.3±1.2, p=0.10) and LVEF (60.1±8.1% vs. 56.3±5.1%, p=0.12) were similar in SSc patients compared to controls.

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Apr 21st, 11:55 AM Apr 21st, 12:20 PM

Effect of Systemic Sclerosis on Myocardial Function, Fibrosis, and Blood Flow Measured by Stress Perfusion Cardiovascular Magnetic Resonance Imaging

Systemic sclerosis (SSc) is a disease that causes multisystem fibrosis and has a 10-year survival of 50-84%. Death is 5-15 times more likely when the heart is affected. Myocardial fibrosis in SSc may interfere with heart muscle contraction, relaxation, and microvascular function, resulting in heart failure, ischemia, and arrhythmias. We sought to quantify the effects of SSc on the heart using cardiac magnetic resonance imaging (CMR). In 11 SSc patients and 11 patients with normal clinical stress perfusion CMR, we measured myocardial perfusion reserve (MPR, ratio of blood flow at stress versus rest), extracellular volume fraction (ECV, a measure of myocardial fibrosis), and left ventricular ejection fraction (LVEF, a measure of systolic function). Transmural analysis was done to analyze subendocardial perfusion. ECV was significantly higher (29.3±3.7% vs. 23.6±2.8%, p<0.001), the subendocardial MPR (1.5±0.6 vs. 2.6±1.6, p=0.06) and subepicardial MPR (1.7±0.7 vs. 2.9±1.7, p=0.05) trended towards being significant, and the whole heart MPR (1.6±0.6 vs. 2.3±1.2, p=0.10) and LVEF (60.1±8.1% vs. 56.3±5.1%, p=0.12) were similar in SSc patients compared to controls.