Quantification of Myocardial Deformation in Patients with Takayasu Arteritis by Cardiovascular Magnetic Resonance Feature Tracking Imaging

Background Cardiac involvement is one of the main causes of morbidity and mortality in patients with Takayasu arteritis (TA). Early detection and intervention of cardiac damage may be helpful to reduce the mortality of TA. Magnetic resonance (MR) imaging (MRI)-derived feature tracking (FT) is an effective quantitative method to assess myocardial deformation which may reflect early changes of cardiac function. Purpose To explore the utility of MR-FT as a method to detect cardiac damage in TA patients. Study Type Retrospective. Population Fifty-seven TA patients who had undergone clinically indicated MRI and 57 healthy controls. Field Strength/Sequences Balanced steady-state free precession rest cine and 2D phase-sensitive inversion recovery breath-hold segmented gradient echo late gadolinium enhancement (LGE) sequences at 3.0 T. Assessment Based on LGE images, TA patients were divided into two subgroups, LGE (+) subgroup (N = 12) and LGE (-) subgroup (N = 45). In addition, patients were further subdivided into impaired (N = 26) and preserved left ventricle ejection fraction (LVEF) subgroups (N = 31). FT-derived deformation indices, including left ventricular (LV) global longitudinal strain (GLS), were measured by commercial software. Statistical Tests Mann-Whitney U-test, Kruskal-Wallis test followed by Dunn-Bonferroni post hoc method, and receiver operating characteristic curve analysis were conducted. A P-value of GLS was significantly worse in TA than in controls (median [interquartile range, IQR]: TA -10.0 [-7.5 to 12.4] vs. controls -12.7 [-11.8 to 14.7]). Moreover, TA patients with LGE (+) had significantly poorer GLS than those with LGE (-) (median [IQR]: LGE (+) -6.8 [-4.0 to 8.1] vs. LGE (-) -10.7 [-8.5 to 12.9]). The reduced LVEF subgroup had significantly greater cardiac dysfunction as measured by MR-FT than the preserved LVEF subgroup (GLS median [IQR]: reduced LVEF -7.9 [-6.2 to 11.4] vs. preserved LVEF -10.8 [-8.6 to 13.5]). Data Conclusion Myocardial deformation impairment was found in the majority of TA patients. MR-FT imaging may be helpful in the early diagnosis and management of TA patients. Level of Evidence 4 Technical Efficacy Stage 5

Automated summary

This study investigated the utility of MR-FT as a method to detect cardiac damage in TA patients and found myocardial deformation impairment in the majority of TA patients. MR-FT imaging may be helpful in the early diagnosis and management of TA patients.