Non-ischemic Primary and Secondary Cardiomyopathy
Maximilian Fenski, MD
Clinical Scientist
Charité – Universitätsmedizin Berlin, ECRC, MDC, Helios Klinikum Berlin Buch, DZHK, Berlin, Germany, Germany
Maximilian Fenski, MD
Clinical Scientist
Charité – Universitätsmedizin Berlin, ECRC, MDC, Helios Klinikum Berlin Buch, DZHK, Berlin, Germany, Germany
Endri Abazi, MD
MD
Charité – Universitätsmedizin Berlin, Charité – Universitätsmedizin Berlin, ECRC, Helios Klinikum Berlin Buch, Germany
Jan Gröschel, MD
MD
Charité – Universitätsmedizin Berlin, ECRC, MDC, DZHK, Germany
Diane Kappelmayer, MD
Consultant Gastroenterologist
HELIOS Hospital Berlin-Buch, Berlin, Germany
Frank Kolligs, MD
Chief Gastroenterologist
HELIOS Hospital Berlin-Buch, Germany
Claudia Prieto, PhD
Professor
King's College London
London, United Kingdom
René M. Botnar, PhD
Professor
King's College London
London, England, United Kingdom
Karl P. Kunze, PhD
Senior Cardiac MR Scientist
Siemens Healthineers
London, England, United Kingdom
Jeanette Schulz-Menger, MD
Professor
Charité – Universitätsmedizin Berlin, ECRC, MDC, Helios Klinikum Berlin Buch, DZHK, Berlin, Germany
Berlin, Berlin, Germany
Active stage of Inflammatory Bowel Disease (IBD) has been linked to increased risk of atrial fibrillation, cardiovascular death and hospitalization for heart failure (1,2). The underlying mechanisms are under debate. We aimed to prospectively assess myocardial alterations in IBD patients with active or remission stages of disease using Cardiac Magnetic Resonance (CMR).
Methods: Forty-one prospectively included patients with histologically and clinically confirmed diagnosis of IBD and twenty-five sex and age matched healthy control subjects underwent CMR imaging on a 1.5 Tesla scanner (MAGNETOM AvantoFit, Siemens Healthcare, Erlangen, Germany). The scan protocol included bSSFP-cine, native T1 (modified Look-Locker inversion recovery) and T2 (T2prep-bSSFP) parametric mapping and prototype 3D whole-heart late gadolinium enhancement (LGE) DIXON fat-water imaging (3). Regions with LGE findings were excluded from T1-mapping analysis. Healthy control subjects underwent a native scan protocol excluding LGE imaging. CMR-images were analyzed using CVI42 software (Circle Cardiovascular Imaging, Calgary, Canada) The stage of the disease was defined using endoscopic and patient reported criteria.
Results: Focal fibrosis on LGE imaging was present in 15% of IBD patients and 43.9% had pericardial effusion. Patients in active, but not in remission stage of disease had significantly higher average basal and medial T1 values (see figure 1) compared with control subjects, despite a low proportion of cardiovascular risk factors (see tables 1 and 2). Left and right ventricular volumes, ejection fractions and left ventricular mass indices were similar between IBD patients and control subjects. T2 parametric mapping did not reveal significantly increased T2 values in IBD patients compared with control subjects.
Conclusion: CMR revealed focal and diffuse subclinical myocardial alterations in patients with acute stage of IBD, but did not show active myocardial inflammation.