Towards the Clinical Management of Cardiac Involvement in Systemic Inflammatory Conditions—a Central Role for CMR
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Purpose of Review
Anti-inflammatory therapies in systemic inflammatory diseases (SID) improve disease-associated disability and may also reduce cardiovascular events. Further optimization of treatment to directly target the inflammation affecting the cardiovascular system represents a potential goal of contemporary treatment. Yet, lack of non-invasive means to detect cardiovascular involvement and to monitor the response to treatment limit such advancements. This is also reflected in the recent 2017 ESC position paper on clinical management of cardiac involvement in SIDs, whose recommendations continue to rely on insensitive, radiation-heavy and invasive diagnostic methods. Absence of evidence and the context of a life-long chronic disease, necessitating ongoing monitoring and serial assessments, puts such recommendations in question. The growing evidence-base for the performance of cardiovascular magnetic resonance (CMR) in patients with SID, and especially of T1 and T2 mapping, offers a viable pathway towards identification of cardiovascular involvement and may potentially guide cardiovascular-specific therapies.
In this review, we appraise the current evidence for the role of CMR in management of cardiac involvement patients with SID.
We propose an interdisciplinary framework with a central role for CMR to support the clinical management of cardiac involvement in SID patients.
KeywordsCardiovascular magnetic resonance Systemic inflammatory diseases Rheumatoid arthritis Systemic lupus erythematosus Cardiac sarcoidosis Non-ischaemic cardiomyopathy T1 mapping T2 mapping
Compliance with Ethical Standards
Conflict of Interest
All authors declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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