Cardiovascular Magnetic Resonance for the Evaluation of Arrhythmogenic Substrates in Patients with Systemic Autoimmunity: An Update

¹ University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair in Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece

² Joint Rheumatology, Laikon Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece

³ Circle Cardiovascular Imaging, 75001 Paris, France

⁴ Institute of Radiology, Department of Medicine, University of Padova, 35128 Padova, Italy

⁵ Section of Internal Medicine, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy

⁶ Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, 20132 Milan, Italy

⁷ Epidemiology Department, University of Manchester, M5 4BR Manchester, UK

⁸ Onassis Cardiac Surgery Center, 17674 Athens, Greece

^*Correspondence: sophie.mavrogeni@gmail.com (Sophie I. Mavrogeni)

Rev. Cardiovasc. Med. 2023, 24(10), 290; https://doi.org/10.31083/j.rcm2410290

Submitted: 22 April 2023 | Revised: 6 July 2023 | Accepted: 25 July 2023 | Published: 12 October 2023

(This article belongs to the Special Issue Research of Cardiovascular Imaging in Autoimmune Rheumatic Diseases)

This is an open access article under the CC BY 4.0 license.

Abstract

Patients with systemic autoimmunity due to autoimmune rheumatic diseases (ARDs) or sarcoidosis frequently present with systemic manifestations including cardiac involvement. Cardiac rhythm disturbances and specifically ventricular arrhythmias (VAs) may affect the prognosis of these patients. Cardiovascular magnetic resonance imaging (CMR) is a non-invasive imaging modality that can provide valuable diagnostic and prognostic information in patients with ARDs or systemic autoimmunity in general. In this narrative review, we briefly present the underlying pathophysiologic mechanisms contributing to arrhythmogenicity in patients with systemic autoimmunity. Furthermore, we discuss recent advances underlying the role and value of CMR for use in the detection and risk stratification of arrhythmogenic substrates in patients with systemic autoimmunity and VAs.

Keywords

oedema

ischemia

fibrosis

inflammation

cardiovascular disease

autoimmune disease

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