PDF(Pubmed)
Abstract：
Cardiac magnetic resonance (CMR) is emerging as the modality of choice to assess early cardiovascular involvement in patients with autoimmune rheumatic diseases (ARDs) that often has a silent presentation and may lead to changes in management. Besides being reproducible and accurate for functional and volumetric assessment, the strength of CMR is its unique ability to perform myocardial tissue characterization that allows the identification of inflammation, edema, and fibrosis. Several CMR biomarkers may provide prognostic information on the severity and progression of cardiovascular involvement in patients with ARDs. In addition, CMR may add value in assessing treatment response and identification of cardiotoxicity related to therapy with immunomodulators that are commonly used to treat these conditions. In this review, we aim to discuss the following objectives: •Illustrate imaging findings of multi-parametric CMR approach in the diagnosis of cardiovascular involvement in various ARDs;•Review the CMR signatures for risk stratification, prognostication, and guiding treatment strategies in ARDs;•Describe the utility of routine and advanced CMR sequences in identifying cardiotoxicity related to immunomodulators and disease-modifying agents in ARDs;•Discuss the limitations of CMR, recent advances, current research gaps, and potential future developments in the field.
摘要：
心脏磁共振（CMR）正在成为评估自身免疫性风湿性疾病（ARD）患者早期心血管受累的首选方式，这些疾病通常具有沉默的表现，并可能导致管理方面的变化。除了可重复和准确的功能和体积评估，CMR的优势在于其独特的心肌组织表征能力，可以识别炎症，水肿,和纤维化。几种CMR生物标志物可以提供ARDs患者心血管受累的严重程度和进展的预后信息。此外,CMR可以在评估治疗反应和鉴定与通常用于治疗这些病症的免疫调节剂的治疗相关的心脏毒性方面增加价值。在这次审查中,我们旨在讨论以下目标：•说明多参数CMR方法在各种ARD心血管受累诊断中的成像发现；•审查CMR特征以进行风险分层，预测,•讨论CMR的局限性,最近的进步，目前的研究空白，以及该领域未来的潜在发展。
