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Cardiac MRI findings in patients with Crohn’s disease

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Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Early cardiac death is more common in patients with Crohn’s disease (CD) than in healthy adults, but the exact cause is unknown.

Aims

The aim of this study is to investigate the cardiac magnetic resonance imaging (MRI) findings in patients with CD and compare the MRI findings with healthy controls (HCs). This study also aimed to demonstrate the possible cardiac involvement in patients with CD using MRI.

Methods

In this prospective study, participants with CD (n = 20) and HC (n = 20) underwent cardiac MRI. Erythrocyte sedimentation rate (ESR) and hematocrit levels were investigated before MRI in both groups. Two observers evaluated the ventricular functional and morphological parameters in consensus. Myocardial T1/T2-relaxation times were calculated by two observers independently using two different software, and hematocrit-corrected left ventricle extracellular volume (LV-ECV) was calculated. Observer-2 also performed histogram analysis for T1/T2-mapping images.

Results

Patients with CD had a significantly higher LV-ECV, mildly decreased right ventricle ejection fraction, and prolonged T2-relaxation time than HC. Moreover, histogram analysis showed that the maximum and mean T2-relaxation times were higher in patients with CD. There was an excellent agreement between observers for the assessment of mean native and post-contrast T1-relaxation time (intraclass correlation coefficient (ICC) of 0.991 and ICC of 0.941, respectively) and mean T2-relaxation time measurements (ICC of 0.983). Moreover, mean T2-relaxation time was found to be significantly correlated with ESR.

Conclusions

This study suggests visually undetectable myocardial involvement due to chronic systemic inflammation in patients with Crohn’s disease. Cardiac MRI can help assess and monitor cardiac involvement in patients with CD.

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Abbreviations

MRI:

Magnetic resonance imaging

LV:

Left ventricle

RV:

Right ventricle

LVEF:

Left ventricular ejection fraction

WBC:

White blood cell

CRP:

C-reactive protein

ESR:

Erythrocyte sedimentation rate

BTFE:

Balanced turbo field echo

sBTFE:

Sine balanced turbo field echo

BBSSh:

Black blood single shot

T2 STIR:

T2-short tau inversion recovery

PSIR:

Phase-sensitive inversion recovery

TF:

Turbo factor

FA:

Flip angle

FOV:

Field of view

Slice Thic.:

Slice thickness.

ECV:

Extracellular volume

Min:

Minimum

Max:

Maximum

Skew:

Skewness

Kurt:

Kurtosis

AUC:

Area under the curve

CI:

Confidence interval

CD:

Crohn’s disease

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Acknowledgements

The authors would like to thank Melahat Kırımlı (Philips healthcare, Turkey) for assistance in analyzing cardiac MR images.

Author information

Author notes

  1. Ibrahim Hasbey and Furkan Ufuk contributed equally and share the first authorship.

Authors and Affiliations

  1. Department of Radiology, University of Pamukkale, Kinikli, 20100, Turkey

    Ibrahim Hasbey & Furkan Ufuk

  2. Department of Radiology, University of Afyon Health Sciences, 03100, Afyonkarahisar, Turkey

    Furkan Kaya

  3. Department of Gastroenterology, University of Pamukkale, Kinikli, 20100, Denizli, Turkey

    Mustafa Celik

Authors
  1. Ibrahim Hasbey
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  2. Furkan Ufuk
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  3. Furkan Kaya
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  4. Mustafa Celik
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Corresponding author

Correspondence to Furkan Ufuk.

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Conflict of interest

The authors declare no competing interests.

The Institutional Review Board statement.

The Institutional Review Board authorization agreement was given to conduct this research at and gather data from Pamukkale University Hospital.

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Key points

•Patients with Crohn’s disease (CD) had a higher myocardial ECV, mildly decreased RV-EF, and prolonged mean T2-relaxation time than healthy participants. There was an excellent agreement between observers for mean native T1, contrast enhanced T1-relaxation time, and mean T2-relaxation time measurements.

•Histogram analysis of T1/T2-mapping images demonstrated the maximum and mean T2-relaxation times were found to be higher in patients with CD, and mean T2-time was significantly correlated with ESR values in the measurements made by both observers with different software.

•The present study results suggest visually undetectable myocardial involvement due to systemic inflammation in patients with CD.

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Hasbey, I., Ufuk, F., Kaya, F. et al. Cardiac MRI findings in patients with Crohn’s disease. Ir J Med Sci 191, 1161–1169 (2022). https://doi.org/10.1007/s11845-021-02717-w

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  • DOI: https://doi.org/10.1007/s11845-021-02717-w

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