title: Cardiovascular magnetic resonance in rheumatology: Current status and recommendations for use.
abstract: Targeted therapies in connective tissue diseases (CTDs) have led to improvements of disease-associated outcomes, but life expectancy remains lower compared to general population due to emerging co-morbidities, particularly due to excess cardiovascular risk. Cardiovascular magnetic resonance (CMR) is a noninvasive imaging technique which can provide detailed information about multiple cardiovascular pathologies without using ionizing radiation. CMR is considered the reference standard for quantitative evaluation of left and right ventricular volumes, mass and function, cardiac tissue characterization and assessment of thoracic vessels; it may also be used for the quantitative assessment of myocardial blood flow with high spatial resolution and for the evaluation of the proximal coronary arteries. These applications are of particular interest in CTDs, because of the potential of serious and variable involvement of the cardiovascular system during their course. The International Consensus Group on CMR in Rheumatology was formed in January 2012 aiming to achieve consensus among CMR and rheumatology experts in developing initial recommendations on the current state-of-the-art use of CMR in CTDs. The present report outlines the recommendations of the participating CMR and rheumatology experts with regards to: (a) indications for use of CMR in rheumatoid arthritis, the spondyloarthropathies, systemic lupus erythematosus, vasculitis of small, medium and large vessels, myositis, sarcoidosis (SRC), and scleroderma (SSc); (b) CMR protocols, terminology for reporting CMR and diagnostic CMR criteria for assessment and quantification of cardiovascular involvement in CTDs; and (c) a research agenda for the further development of this evolving field.
authors.affiliation: Onassis Cardiac Surgery Center, Athens, Greece. Electronic address: soma13@otenet.gr.
authors.forename: Sophie I
authors.initials: SI
authors.lastname: Mavrogeni
authors.affiliation: Arthritis Research UK Epidemiology Unit, Manchester University, Manchester, UK.
authors.forename: George D
authors.initials: GD
authors.lastname: Kitas
authors.affiliation: Department of Rheumatology, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, West Midlands, DY1 2LT, UK.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Dimitroulas
authors.affiliation: First Department of Propeudeutic and Internal medicine, Laikon Hospital, Athens University Medical School, Athens, Greece.
authors.forename: Petros P
authors.initials: PP
authors.lastname: Sfikakis
authors.affiliation: Department of Rheumatology, John's Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Seo
authors.affiliation: Department of Medicine (Rheumatology) and Epidemiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Sherine
authors.initials: S
authors.lastname: Gabriel
authors.affiliation: University of Chicago, Department of Medicine, Chicago, IL, USA.
authors.forename: Amit R
authors.initials: AR
authors.lastname: Patel
authors.affiliation: Institute of Clinical Physiology, National Research Council, Pisa, Italy.
authors.forename: Luna
authors.initials: L
authors.lastname: Gargani
authors.affiliation: Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bombardieri
authors.affiliation: Experimental and Clinical Medicine, Division of Internal Medicine and Rheumatology, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci-Cerinic
authors.affiliation: Multimodality Cardiac Imaging Section, Policlinico San Donato, Milano, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Lombardi
authors.affiliation: Magnetic Resonance Imaging Unit, Fondazione G. Monasterio C.N.R., Pisa, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Pepe
authors.affiliation: Laboratory of Computing and Medical Informatics, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Anthony H
authors.initials: AH
authors.lastname: Aletras
authors.affiliation: Onassis Cardiac Surgery Center, Athens, Greece.
authors.forename: Genovefa
authors.initials: G
authors.lastname: Kolovou
authors.affiliation: Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland; Center for Diagnosis, Prevention and Telemedicine, John Paul II Hospital, Kraków, Poland; Department of Clinical Radiology and Imaging Diagnostics, 4th Military Hospital, Wroclaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Miszalski
authors.affiliation: Department of Rheumatology, Radbound University Medical Centre, Radbound, The Netherlands.
authors.forename: Piet
authors.initials: P
authors.lastname: van Riel
authors.affiliation: Preventive Cardio-Rheuma clinic, Dept Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: AnneGrete
authors.initials: A
authors.lastname: Semb
authors.affiliation: Health Research Institute of Santiago de Compostela (IDIS), Division of Rheumatology, Clinical University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Gonzalez-Gay
authors.affiliation: Cardiovascular Pathophysioloy and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Patrick
authors.initials: P
authors.lastname: Dessein
authors.affiliation: David Geffen School of Medicine-UCLA Chief, Division of Rheumatology, London, UK.
authors.forename: George
authors.initials: G
authors.lastname: Karpouzas
authors.affiliation: University Hospital Frankfurt, Frankfurt, UK.
authors.forename: Valentina
authors.initials: V
authors.lastname: Puntmann
authors.affiliation: University Hospital Frankfurt, Frankfurt, UK.
authors.forename: Eike
authors.initials: E
authors.lastname: Nagel
authors.affiliation: King's College, London, UK.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Bratis
authors.affiliation: Athens Naval Hospital, Athens, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Karabela
authors.affiliation: Athens Naval Hospital, Athens, Greece.
authors.forename: Efthymios
authors.initials: E
authors.lastname: Stavropoulos
authors.affiliation: Athens Naval Hospital, Athens, Greece.
authors.forename: Gikas
authors.initials: G
authors.lastname: Katsifis
authors.affiliation: Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Loukia
authors.initials: L
authors.lastname: Koutsogeorgopoulou
authors.affiliation: Dept Cardiology, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: van Rossum
authors.affiliation: Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Rademakers
authors.affiliation: Department of Cardiology, University of South California, LA, USA.
authors.forename: Gerald
authors.initials: G
authors.lastname: Pohost
authors.affiliation: Department of Medicine, Radiology and Epidemiology Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
mesh_terms: D003240:Connective Tissue Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D032921:Consensus; D006321:Heart / Q000503:physiopathology; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D017410:Practice Guidelines as Topic; D012307:Risk Factors
keywords: Cardiovascular magnetic resonance imaging; Rheumatic diseases