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Review
. 2018 Feb 14:5:26.
doi: 10.3389/fmed.2018.00026. eCollection 2018.

Cardiovascular Imaging Techniques in Systemic Rheumatic Diseases

Fabiola Atzeni  1 , Marco Corda  2 , Luigi Gianturco  3 , Maurizio Porcu  2 , Piercarlo Sarzi-Puttini  4 , Maurizio Turiel  3
Affiliations
Review

Cardiovascular Imaging Techniques in Systemic Rheumatic Diseases

Fabiola Atzeni et al. Front Med (Lausanne). .

Abstract

The risk of cardiovascular (CV) events and mortality is significantly higher in patients with systemic rheumatic diseases than in the general population. Although CV involvement in such patients is highly heterogeneous and may affect various structures of the heart, it can now be diagnosed earlier and promptly treated. Various types of assessments are employed for the evaluation of CV risk such as transthoracic or transesophageal echocardiography, magnetic resonance imaging (MRI), and computed tomography (CT) to investigate valve abnormalities, pericardial disease, and ventricular wall motion defects. The diameter of coronary arteries can be assessed using invasive quantitative coronarography or intravascular ultrasound, and coronary flow reserve can be assessed using non-invasive transesophageal or transthoracic ultrasonography (US), MRI, CT, or positron emission tomography (PET) after endothelium-dependent vasodilation. Finally, peripheral circulation can be measured invasively using strain-gauge plethysmography in an arm after the arterial infusion of an endothelium-dependent vasodilator or non-invasively by means of US or MRI measurements of flow-mediated vasodilation of the brachial artery. All of the above are reliable methods of investigating CV involvement, but more recently, introduced use of speckle tracking echocardiography and 3-dimensional US are diagnostically more accurate.

Keywords: atherosclerosis; computed tomography; coronary artery diseases; endothelial dysfunction; plasma asymmetric dimethylarginine; systemic rheumatic diseases.

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Figures

Figure 1
Figure 1
Example of coronary flow Doppler signal during dypiridamole-induced hyperemia. S, systolic flow; D, diastolic flow.
Figure 2
Figure 2
STE: systolic myocardial deformation after electromechanical activation. LV: longitudinal strain from the apical four-chamber view: time–strain curves show a negative end-systolic strain representing myocardial shortening during systole.
Figure 3
Figure 3
CRMI: a patient with previous anterior myocardial infarction. Late enhancement imaging showed transmural infarction in the left anterior descending artery.
Figure 4
Figure 4
Cardiac CT: patient with high-grade left anterior descending artery stenosis (arrow).
Figure 5
Figure 5
Coronary CT: chronic total occlusion of left anterior descending artery.
Figure 6
Figure 6
Coronary TC: chronic total occlusion of left anterior descending artery.
See this image and copyright information in PMC

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References

    1. Knockaert DC. Cardiac involvement in systemic inflammatory diseases. Eur Heart J (2007) 28(15):1797–804.10.1093/eurheartj/ehm193 - DOI - PubMed
    1. Tanasescu C, Jurcut C, Jurcut R, Ginghina C. Vascular disease in rheumatoid arthritis: from subclinical lesions to cardiovascular risk. Eur J Intern Med (2009) 20(4):348–54.10.1016/j.ejim.2008.09.005 - DOI - PubMed
    1. Gianturco L, Bodini BD, Atzeni F, Colombo C, Stella D, Sarzi-Puttini P, et al. Cardiovascular and autoimmune diseases in females: the role of microvasculature and dysfunctional endothelium. Atherosclerosis (2015) 241(1):259–63.10.1016/j.atherosclerosis.2015.03.044 - DOI - PubMed
    1. Turiel M, Sitia S, Tomasoni L, Cicala S, Atzeni F, Gianturco L, et al. Cardiac involvement in rheumatoid arthritis. Reumatismo (2009) 61(4):244–53. - PubMed
    1. Sattar N, McCarey DW, Capell H, McInnes IB. Explaining how “high-grade” systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation (2003) 108(24):2957–63.10.1161/01.CIR.0000099844.31524.05 - DOI - PubMed