Asymptomatic myocardial dysfunction was revealed by feature tracking cardiac magnetic resonance imaging in patients with primary Sjögren's syndrome

Int J Rheum Dis. 2021 Dec;24(12):1482-1490. doi: 10.1111/1756-185X.14227. Epub 2021 Oct 25.

Abstract

Aim: To evaluate subclinical left ventricular (LV) regional dysfunction in patients with primary Sjögren's syndrome (pSS) using feature tracking cardiac magnetic resonance (FT-CMR) imaging and to identify pSS characteristics independently associated with LV regional dysfunction.

Method: Fifty patients with pSS and 20 controls without cardiovascular disease underwent non-contrast CMR imaging. Labial gland biopsy was performed in 42 patients (84%). Disease activity was assessed using the European League Against Rheumatism Sjögren's syndrome disease activity index (ESSDAI). LV global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were measured using FT-CMR.

Results: No significant differences in cardiovascular risk factors were found between the pSS group and controls. The pSS group had significantly lower GLS (P = .015) and GCS (P = .008) than the control group. Multiple linear regression analysis indicated that GCS was significantly associated with Raynaud's phenomenon (P = .015), focus score ≥2 (P = .032), and total ESSDAI score ≥8 (P = .029).

Conclusion: FT-CMR can reveal subclinical LV regional dysfunction in patients with pSS without cardiovascular disease. Furthermore, patients with pSS and Raynaud's phenomenon, a focus score ≥2, or an ESSDAI score ≥8 were considered to be at high risk for myocardial dysfunction.

Keywords: European League Against Rheumatism Sjӧgren's syndrome disease activity index; Raynaud's phenomenon; feature tracking cardiac magnetic resonance imaging; focus score; global longitudinal strain; left ventricular regional function; primary Sjögren's syndrome.

MeSH terms

  • Asymptomatic Diseases
  • Cardiac Imaging Techniques / methods
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Raynaud Disease / complications
  • Sjogren's Syndrome / blood
  • Sjogren's Syndrome / complications
  • Sjogren's Syndrome / physiopathology*
  • Ventricular Dysfunction, Left / diagnosis*
  • Ventricular Dysfunction, Left / etiology