Towards the Clinical Management of Cardiac Involvement in Systemic Inflammatory Conditions —a Central Role for CMR

AbstractPurpose of ReviewAnti-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.Recent FindingsIn this review, we appraise the current evidence for the role of CMR in management of cardiac involvement patients with SID.SummaryWe propose an interdisciplinary framework with a central role for CMR to support the clinical management of cardiac involvement in SID patients.
Source: Current Cardiovascular Imaging Reports - Category: Radiology Source Type: research