MRI Has Distinct Potential to Detect Heart Problems in Scleroderma Patients, Study Suggests

Magnetic resonance imaging (MRI), a medical technique used to form detailed pictures of the inside of our bodies, has the potential to detect and diagnose abnormalities in the hearts of patients with scleroderma, a study suggests.

According to researchers involved in the study, MRI identified abnormalities in the hearts of 73 percent of the patients studied, including changes in the structure and function of the heart.

The findings were reported in the study “Value of cardiac magnetic resonance imaging in systemic sclerosis,” published in the journal Reumatologia.

MRI has been used as a diagnostic tool for diverse medical disorders, including neurological, musculoskeletal, and gastrointestinal diseases. The technique was applied only recently in the cardiac field, having proved to be an accurate and sensitive method to assess heart function and structure in a non-invasive manner.

Scleroderma, which is characterized by the damage and thickening (fibrosis) of several organs in the body, including the heart, may represent an ideal target for MRI diagnosis.

To test this hypothesis, two researchers at Khon Kaen University, Thailand, investigated the use of cardiac MRI to identify abnormalities in the structure and function of the heart of scleroderma patients.

The study included 26 patients undergoing cardiac MRI between February 2013 and September 2016.

Results showed that cardiac MRI results were used to identify at least one abnormality in 19 of 26 patients (73%).

Among them, an increased intensity of a heart signal (myocardial signal) was observed in 10 patients (38.5%), and thinning of the heart’s left ventricle was detected in one patient (3.5 %). Pericardial effusion, a condition characterized by excess fluid between the heart and the sac surrounding it, was diagnosed in 12 patients (46%).

Left and right ventricular ejection fractions, both well-established measures of the heart’s function, were altered in 10 (38.5%) and 11 (42%) patients, respectively.

Cardiac MRI results also showed that patients with localized scleroderma (16 patients) had similar heart abnormalities to patients with systemic scleroderma (10 patients).

Importantly, this technique provided more information about heart inflammation and fibrosis, and had a higher sensitivity (the ability of a test to correctly identify those with the disease) compared to echocardiography of the heart.

The “sensitivity of cardiac MRI to detect cardiac abnormalities was 21/26 (81%) as compared to 11/26 (42%) for echocardiography,” the researchers wrote.

Based on the results, the team concluded: “… cardiac MRI is an accurate and reliable technique to diagnose cardiac involvement in systemic sclerosis and to analyze precisely its mechanisms, including inflammatory, microvascular and fibrotic components.”

“As it is non-invasive, quantitative and highly sensitive, cardiac MRI appears to be a method of choice to determine the natural history of untreated patients or to accurately monitor the effects of treatment,”  researchers added.