title: Impact of cardiac magnetic resonance imaging on eosinophilic granulomatosis with polyangiitis outcomes: A long-term retrospective study on 42 patients.
abstract: OBJECTIVE
  To determine the diagnostic and prognostic significance of cardiac magnetic resonance imaging (CMRI) in a cohort of patients with eosinophilic granulomatosis with polyangiitis (EGPA).
  
  
  METHODS
  We conducted a monocentric retrospective study including 42 EGPA patients who had consecutively undergone CMRI at diagnosis or during follow-up, independently of signs of cardiac involvement.
  
  
  RESULTS
  Forty-two patients (male 59.5%, mean age at diagnosis 46.5 years) were included. ANCA was positive in 26.2%, and median EGPA duration before the 1st CMRI screening was 5 months. Seventeen (40.5%) were diagnosed with cardiomyopathy, independently of CMRI findings. CMRI showed myocardial late gadolinium enhancement (LGE) in 82.4% patients with cardiomyopathy vs. 44% without cardiomyopathy (P=0.024). Using LGE as the sole criterion, CMRI sensitivity and specificity for diagnosing cardiomyopathy were 82.4% and 56%, respectively. Among the 15 patients with cardiomyopathy who underwent additional CMRI during follow-up, CMRI-detected cardiac lesions had improved in 7 patients, while those of 8 patients worsened or stabilized despite treatment. These latter patients presented with significantly more cardiac events during follow-up (P=0.026). No differences were found between non-cardiomyopathic patients with or without CMRI anomalies concerning EGPA cardiac manifestations and outcomes.
  
  
  CONCLUSIONS
  The diagnostic significance of myocardial LGE in EGPA patients remains uncertain and should not be the only criterion for cardiomyopathy diagnosis. For patients with no other signs of cardiomyopathy, CMRI-detected anomalies do not seem to adversely affect prognosis or outcome. For patients with cardiomyopathy, CMRI reassessment seems promising in detecting patients with a less favorable cardiac outcome.
authors.affiliation: Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France. Electronic address: bertrand.dunogue@cch.aphp.fr.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Dunogué
authors.affiliation: Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Terrier
authors.affiliation: Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Cohen
authors.affiliation: Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Marmursztejn
authors.affiliation: Department of Radiology and Cardiovascular Imaging, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Legmann
authors.affiliation: Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Mouthon
authors.affiliation: Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Duboc
authors.affiliation: Department of Radiology and Cardiovascular Imaging, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Vignaux
authors.affiliation: Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris 5, Hôpital Cochin, Paris, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Guillevin
mesh_terms: D004804:Eosinophils; D014890:Granulomatosis with Polyangiitis / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009206:Myocardium / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies
keywords: Cardiac magnetic resonance imaging; Cardiomyopathy; Eosinophilic granulomatosis with polyangiitis; Prognosis