Salivary Gland Focus Score Is Associated With Myocardial Fibrosis in Primary Sjögren Syndrome Assessed by a Cardiac Magnetic Resonance Approach.

J Rheumatol

A. Nishiwaki, MD, H. Kobayashi, MD, PhD, N. Ikumi, MD, K. Sugiyama, MD, PhD, Y. Matsukawa, MD, PhD, M. Takei, MD, PhD, N. Kitamura, MD, PhD, Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo;

Published: June 2021

AI Article Synopsis

  • This study investigates the risk of major cardiovascular events in patients with primary Sjögren syndrome (pSS) by assessing myocardial fibrosis using cardiac magnetic resonance imaging (cMRI).
  • It involved 52 women aged around 55, where 19% showed signs of myocardial fibrosis, even without any cardiac symptoms.
  • The findings indicate a link between abnormal cMRI results and severe salivary gland involvement in pSS patients, suggesting potential underlying heart issues despite the absence of symptoms.

Article Abstract

Objective: The risk of clinically manifested major cardiovascular (CV) events in primary Sjögren syndrome (pSS) remains unclear. This study aimed to assess myocardial fibrosis in pSS and investigate the associated disease characteristics by cardiac magnetic resonance imaging (cMRI).

Methods: We performed a cross-sectional study of patients with pSS without cardiac symptoms. Labial gland biopsy was documented in 44 patients (85%). Patients without CV risk factors underwent contrast-enhanced cMRI. Late gadolinium enhancement (LGE) was used to assess myocardial fibrosis. Myocardial edema was assessed using T2-weighted imaging (T2WI). We compared the left ventricular (LV) geometry and function between the groups with and without LGE. Further, we explored the associations of cMRI abnormalities with pSS characteristics.

Results: Fifty-two women with pSS (median age 55, IQR 47.0-65.7 yrs) were enrolled in the study. LGE was observed in 10 patients (19%), two of whom showed high intensity on T2WI. High intensity on T2WI was observed in 3 patients (5.8%). LV mass index and LV mass/end-diastolic volume tended to be higher in the LGE-positive group than in the LGE-negative group ( = 0.078 and 0.093, respectively). Salivary gland focus score (FS) ≥ 3 was independently associated with LGE-positive in the multivariable analysis (OR 11.21, 95% CI 1.18-106.80).

Conclusion: Subclinical myocardial fibrosis, as detected by cMRI, was frequent in patients with pSS without cardiac symptoms. Abnormal cMRI findings were associated with salivary gland FS ≥ 3.

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http://dx.doi.org/10.3899/jrheum.200352DOI Listing

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