Objectives: To evaluate the effects of immunosuppressive therapy on cardiac abnormalities observed by cardiac magnetic resonance imaging (CMRI) in patients with Churg-Strauss syndrome (CSS).
Methods: We studied 8 patients with CSS and myocardial involvement on initial CMR images, who underwent follow-up CMRI after 6 months of immunosuppressive therapy.
Results: Among the 8 patients (mean age: 43 years; 4 women), 7 had clinical cardiac signs at CSS onset (cardiac insufficiency, 3; angina pectoris, 2; atrial fibrillation, 1; and pericarditis, 1); 4 of them had myocardial-delayed enhancement, 2 had perfusion defects and 1 had both CMRI anomalies. The patient without clinical manifestations of heart disease had myocardial delayed enhancement on CMRI. After 6 months of therapy, CMR images normalised for the patient without clinical cardiac signs at diagnosis, and 3 symptomatic patients, and abnormalities had regressed for 2 other symptomatic patients. Theses 5 initially symptomatic patients became asymptomatic after immunosupressive treatment. The last 2 patients with cardiac insufficiency at CSS diagnosis are still symptomatic with unchanged CMRI abnormalities.
Conclusions: CMRI is a sensitive, non-invasive method to detect cardiac lesions in patients whose conventional investigations indicated no cardiac disease and to assess the extent of cardiac involvement in symptomatic patients. CMRI can help evaluate the therapeutic effect of immunosuppressants in CSS.