Cardiac involvement in Wegener’s granulomatosis resistant to induction therapy
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Tomasz Miszalski-Jamka &Wojciech Szczeklik & Barbara Soko³owska & Karol Miszalski-Jamka & Krzysztof Karwat & Gabriel Grz¹dziel &Wojciech Mazur & Dea
- چاپ و سال / کشور: 2011
Description
Objectives The aim of the study was to assess cardiac involvement in patients with Wegener’s granulomatosis (WG), who failed to achieve remission following >6 months induction therapy for life or organ threatening disease. Methods Eleven WG patients (eight males, mean age 47± 13 years), who failed to achieve remission despite >6 months induction therapy, underwent transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR). Results Cardiac involvement was present in 9 (82%) patients. Regional wall motion abnormalities were found in two individuals, but none had left ventricular (LV) ejection fraction <50%. Nine patients had late gadolinium enhancement (LGE) lesions involving LV myocardium and right ventricle free wall was involved in four patients. LGE lesions were found in subepicardial, midwall and subendocardial LV myocardial layers. CMR revealed myocarditis in six patients. Patients with myocarditis had a higher number of LV segments with LGE (5.2±3.4 vs 1.0±1.2, p=0.03) and more frequent diastolic dysfunction by TTE (5 vs 0, p=0.02) than those without. Pericardial effusion was observed in five patients, while localized pericardial thickening in six patients. Conclusions In WG resistant to >6 months induction therapy cardiac involvement is frequent and is characterized by foci of LGE lesions and signs of myocardial inflammatory process.
Eur Radiol DOI 10.1007/s00330-011-2203-6 Received: 13 February 2011 / Revised: 12 May 2011 / Accepted: 31 May 2011
