{
  "abstract": "Introduction Cardiopulmonary involvement in systemic sclerosis (SSc) represents the major causes of mortality. Primary heart involvement (pHI) is well-recognised, with multiparametric cardiovascular magnetic resonance (CMR) able to characterise myocardial tissue for oedema and fibrosis. Interstitial lung disease (ILD) is a risk factor for pHI but the temporal relationship between heart and lung involvement is unclear and whilst computed tomography (CT) imaging is the gold standard for ILD, distinguishing inflammation from fibrosis is not reliable.Objective A pilot study using a combined cardio-pulmonary MRI (CP-MRI) protocol to assess myocardial and pulmonary tissue characteristics in SSc patients.Material and Methods SSc patients enriched for ILD were recruited and underwent gadolinium-based contrast CP-MRI (3T, Magnetom Vida, Siemens) protocol capturing volumetric indices and tissue measures - cardiac and pulmonary T1 mapping, cardiac and pulmonary T2 mapping and myocardial late gadolinium enhancement (LGE). Myocardial T1 and T2 mapping values were compared to age- and sex- matched healthy controls on the same scanner ; ECV values were compared to literature references . Image analysis was performed using Circle CVI (v 5.6.7). Statistical analyses were performed using R (v 4.5.1).Results Seventeen patients (12 with ILD) were recruited; baseline characteristics are presented in table 1.Compared to controls, the SSc cohort had elevated median native myocardial T1 mapping 1249 milliseconds (ms), (IQR 1196-1291, p=0.03), myocardial T2 mapping 43ms (IQR 40.5-45.5, p = 0.002) and ECV 31.2% (IQR 28.5-34.8, p <0.0001). Myocardial tissue measures (LGE, T1 mapping, ECV and/or T2) were abnormal in 15 patients and updated Lake Louise Criteria for myocarditis satisfied in 4/17.Initial analysis of whole lung median T1 was 1516ms (IQR 1490-1570) and T2 38ms (IQR 32.5-40.5). There are no established normative values in the literature regarding pulmonary T1 or T2 mapping.Cardiac T1 and T2 showed weak correlations with corresponding pulmonary T1 and T2 (Spearman rho = 0.17 and 0.10 respectively) but cross correlations were stronger (cardiac T1 vs pulmonary T2 rho =0.58; cardiac T2 vs pulmonary T1 rho = 0.47) (figures 1&2).Conclusions This first combined cardiopulmonary MRI study in SSc characterised pulmonary T1 and T2 levels alongside subclinical myocardial tissue abnormalities of myocardial fibrosis and oedema. Further study of this cohort including pulmonary region of interest (ROI) analysis will delineate pulmonary tissue abnormalities and whether the strongest correlation of myocardial T1-pulmonary T2 implies myocardial oedema alongside pulmonary tissue oedema or asynchronous myocardial fibrosis and lung inflammation.Abstract P.146 Figure 1Cardiac T1 and pulmonary T2 correlationAbstract P.146 Figure 2Cardiac T2 and pulmonary T1 correlationAbstract P.146 Table 1Baseline characteristics",
  "authors": [
    {
      "affiliations": [
        "Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom"
      ],
      "name": "Rushab Shah"
    },
    {
      "affiliations": [
        "Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom"
      ],
      "name": "Nicholas Black"
    },
    {
      "affiliations": [
        "Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom"
      ],
      "name": "John Farrant"
    },
    {
      "affiliations": [
        "Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom"
      ],
      "name": "Hashem Cheema"
    },
    {
      "affiliations": [
        "Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom"
      ],
      "name": "Jyotin Singh"
    },
    {
      "affiliations": [
        "Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom"
      ],
      "name": "Cristiana Sieiro Santos"
    },
    {
      "affiliations": [
        "Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom"
      ],
      "name": "Josephine Naish"
    },
    {
      "affiliations": [
        "Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom"
      ],
      "name": "Christopher Miller"
    },
    {
      "affiliations": [
        "Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom"
      ],
      "name": "Maya Buch"
    }
  ],
  "title": "P.146 Magnetic resonance cardiopulmonary tissue characteristics in a systemic sclerosis cohort: a pilot study",
  "uid": "b984bc33-ad93-545d-8065-37631567e276"
}