title: Cardiac magnetic resonance imaging in Churg-Strauss-syndrome. Impact of immunosuppressants on outcome assessed in a prospective study on 8 patients.
abstract: OBJECTIVE
  To evaluate the effects of immunosuppressive therapy on cardiac abnormalities observed by cardiac magnetic resonance imaging (CMRI) in patients with Churg-Strauss syndrome (CSS).
  
  
  METHODS
  We studied 8 patients with CSS and myocardial involvement on initial CMR images, who underwent follow-up CMRI after 6 months of immunosuppressive therapy.
  
  
  RESULTS
  Among the 8 patients (mean age: 43 years; 4 women), 7 had clinical cardiac signs at CSS onset (cardiac insufficiency, 3; angina pectoris, 2; atrial fibrillation, 1; and pericarditis, 1); 4 of them had myocardial-delayed enhancement, 2 had perfusion defects and 1 had both CMRI anomalies. The patient without clinical manifestations of heart disease had myocardial delayed enhancement on CMRI. After 6 months of therapy, CMR images normalised for the patient without clinical cardiac signs at diagnosis, and 3 symptomatic patients, and abnormalities had regressed for 2 other symptomatic patients. Theses 5 initially symptomatic patients became asymptomatic after immunosupressive treatment. The last 2 patients with cardiac insufficiency at CSS diagnosis are still symptomatic with unchanged CMRI abnormalities.
  
  
  CONCLUSIONS
  CMRI is a sensitive, non-invasive method to detect cardiac lesions in patients whose conventional investigations indicated no cardiac disease and to assess the extent of cardiac involvement in symptomatic patients. CMRI can help evaluate the therapeutic effect of immunosuppressants in CSS.
authors.affiliation: Department of Cardiology, Hopital Cochin, Université de Paris, France. julien.marmursztejn@cch.aphp.fr
authors.forename: Julien
authors.initials: J
authors.lastname: Marmursztejn
authors.forename: Pascal
authors.initials: P
authors.lastname: Cohen
authors.forename: Denis
authors.initials: D
authors.lastname: Duboc
authors.forename: Christian
authors.initials: C
authors.lastname: Pagnoux
authors.forename: Luc
authors.initials: L
authors.lastname: Mouthon
authors.forename: Philippe
authors.initials: P
authors.lastname: Guilpain
authors.forename: Paul
authors.initials: P
authors.lastname: Legmann
authors.forename: Loic
authors.initials: L
authors.lastname: Guillevin
authors.forename: Olivier
authors.initials: O
authors.lastname: Vignaux
mesh_terms: D000328:Adult; D015267:Churg-Strauss Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology*; D016903:Drug Monitoring / Q000379:methods; D042241:Early Diagnosis; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000187:drug effects
chemical_list: D007166:Immunosuppressive Agents