Determinants of myocardial fibrosis in patients with immune-mediated inflammatory diseases.

IF 2 4区医学 Q3 RHEUMATOLOGY

Advances in Rheumatology Pub Date : 2025-06-14 DOI:10.1186/s42358-025-00451-w

Nicholas Black, Joshua Bradley, Fardad Soltani, John P Farrant, Josephine H Naish, Matthias Schmitt, Maya H Buch, Christopher A Miller

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引用次数: 0

Abstract

Background: Myocardial fibrosis is an important adverse prognostic marker, however; determinants of myocardial fibrosis in immune-mediated inflammatory diseases (IMIDs) remain poorly defined. We aimed to identify determinants of myocardial fibrosis in patients with IMIDs, as measured by cardiovascular magnetic resonance (CMR) extracellular volume (ECV).

Methods: Cross-sectional study of 116 patients with IMIDs undergoing clinical CMR at Manchester University NHS Foundation Trust. IMIDs included rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis (SSc), ankylosing spondylitis, psoriatic arthritis and vasculitis. CMR included pre- and post-contrast T1 mapping to measure myocardial ECV, with same day blood sampling. Determinants of ECV were investigated with univariable and multivariable linear regression.

Results: ECV varied significantly according to IMID diagnosis (ANOVA F statistic 2.80, P = 0.015); ECV was higher in patients with SSc compared to other IMIDs. Major determinants of ECV as a continuous variable were SSc, smoking and body mass index (BMI); regression coefficients 3.33 (95% confidence interval 0.82-5.84), 3.08 (0.73-5.43), and - 0.19 (-0.29 - -0.09) respectively, P < 0.01 (SSc, smoking and lower BMI were associated with increased ECV). Approximately a quarter of the variability in ECV could be explained by these predictors (optimism adjusted R² 0.265).

Conclusion: SSc is associated with a higher burden of myocardial fibrosis compared to other IMIDs. In patients with IMIDs, independent determinants of myocardial fibrosis were presence of SSc, smoking and BMI. Importantly, participants underwent CMR for clinical indications and may not be representative of IMID populations in the community.

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免疫介导的炎症性疾病患者心肌纤维化的决定因素

背景：然而，心肌纤维化是一个重要的不良预后指标；免疫介导的炎症性疾病（IMIDs）中心肌纤维化的决定因素仍然不明确。我们的目的是通过心血管磁共振（CMR）细胞外体积（ECV）来确定IMIDs患者心肌纤维化的决定因素。方法：对116例在曼彻斯特大学NHS基金会信托接受临床CMR治疗的IMIDs患者进行横断面研究。IMIDs包括类风湿关节炎、系统性红斑狼疮、系统性硬化症（SSc）、强直性脊柱炎、银屑病关节炎和血管炎。CMR包括造影前和造影后T1制图，测量心肌ECV，并在当天采血。采用单变量和多变量线性回归研究了ECV的决定因素。结果：ECV根据IMID诊断有显著差异（方差分析F值为2.80,P = 0.015）；与其他IMIDs相比，SSc患者的ECV更高。作为连续变量的ECV的主要决定因素是SSc、吸烟和体重指数（BMI）；回归系数分别为3.33（95%置信区间0.82 ~ 5.84）、3.08（0.73 ~ 5.43）、- 0.19 (-0.29 ~ -0.09),P < 0.05)。结论：与其他IMIDs相比，SSc与更高的心肌纤维化负担相关。在IMIDs患者中，心肌纤维化的独立决定因素是SSc、吸烟和BMI的存在。重要的是，参与者因临床适应症而接受CMR，可能不能代表社区中的IMID人群。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Rheumatology Medicine-Rheumatology

CiteScore

4.00

自引率

4.30%

发文量

审稿时长

53 weeks

期刊介绍： Formerly named Revista Brasileira de Reumatologia, the journal is celebrating its 60th year of publication. Advances in Rheumatology is an international, open access journal publishing pre-clinical, translational and clinical studies on all aspects of paediatric and adult rheumatic diseases, including degenerative, inflammatory and autoimmune conditions. The journal is the official publication of the Brazilian Society of Rheumatology and welcomes original research (including systematic reviews and meta-analyses), literature reviews, guidelines and letters arising from published material.