Cardiovascular magnetic resonance imaging detects cardiac involvement in Churg-Strauss syndrome.
BACKGROUND
Cardiac involvement in Churg-Strauss vasculitis worsens the prognosis. Early detection is, therefore, warranted. Cardiac magnetic resonance (CMR) can visualize various forms of inflammatory changes in the myocardium. We tested whether CMR could elucidate cardiac damage in patients with biopsy-proven Churg-Strauss syndrome and clinical evidence of cardiac involvement.


RESULTS
Eleven patients underwent a CMR protocol including cine imaging for left ventricular function in long axes, T2-weighted imaging for edema detection, and contrast-enhanced T1-weighting for early and late gadolinium enhancement. CMR detected various form of myocardial injury in all patients. Systolic left ventricular function was impaired in 6 patients. Mean left ventricular ejection fraction was 45 +/- 15%. Left ventricular size was mildly enlarged (left ventricular end-diastolic volume index 94 +/- 23 mL/m(2)). Edema was present in 4 cases; 7 patients had pericardial effusion. Six patients had increased early contrast uptake. CMR detected late enhancement lesions in 9 of 11 patients, even in those with normal left ventricular size and function.


CONCLUSIONS
CMR has the potential to detect myocardial injury in Churg-Strauss syndrome even when left ventricular function appears normal.
Wassmuth
Ralf
R
Cardiology Department, Franz-Volhard-Klinik, Charite Campus Buch, and HELIOS-Klinikum Berlin, Berlin, Germany. ralf.wassmuth@charite.de
Göbel
Ursula
U
Natusch
Alexander
A
Schneider
Wolfgang
W
Kettritz
Ralph
R
Dietz
Rainer
R
Luft
Friedrich C
FC
Schulz-Menger
Jeanette
J
D000328:Adult; D000368:Aged; D002319:Cardiovascular System / Q000473:pathology; D015267:Churg-Strauss Syndrome / Q000175:diagnosis / Q000473:pathology*; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D010865:Pilot Projects