Cardiac involvement in Wegener’s granulomatosis resistant to induction therapyReport as inadecuate

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European Radiology

, 21:2297

First Online: 23 July 2011Received: 13 February 2011Revised: 12 May 2011Accepted: 31 May 2011


ObjectivesThe aim of the study was to assess cardiac involvement in patients with Wegener’s granulomatosis WG, who failed to achieve remission following >6 months induction therapy for life or organ threatening disease.

MethodsEleven WG patients eight males, mean age 47 ± 13 years, who failed to achieve remission despite >6 months induction therapy, underwent transthoracic echocardiography TTE and cardiac magnetic resonance CMR.

ResultsCardiac involvement was present in 9 82% patients. Regional wall motion abnormalities were found in two individuals, but none had left ventricular LV ejection fraction <50%. Nine patients had late gadolinium enhancement LGE lesions involving LV myocardium and right ventricle free wall was involved in four patients. LGE lesions were found in subepicardial, midwall and subendocardial LV myocardial layers. CMR revealed myocarditis in six patients. Patients with myocarditis had a higher number of LV segments with LGE 5.2 ± 3.4 vs 1.0 ± 1.2, p = 0.03 and more frequent diastolic dysfunction by TTE 5 vs 0, p = 0.02 than those without. Pericardial effusion was observed in five patients, while localized pericardial thickening in six patients.

ConclusionsIn WG resistant to >6 months induction therapy cardiac involvement is frequent and is characterized by foci of LGE lesions and signs of myocardial inflammatory process.

KeywordsWegener’s granulomatosis Cardiac magnetic resonance Echocardiography Myocarditis Remission  Download fulltext PDF

Author: Tomasz Miszalski-Jamka - Wojciech Szczeklik - Barbara Sokołowska - Karol Miszalski-Jamka - Krzysztof Karwat - Gabriel Grzą


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