Abstract 3023: Coronary Artery And Viability Evaluation In Anca-Associated Vasculitides Using Magnetic Resonance Imaging
Microscopic Polyangiitis (MPA), Wegener’s Granulomatosis (WG) and Churg-Strauss syndrome (CSS) are forms of necrotizing vasculitis with a varying prevalence of ANCA positivity. CA can be occasionally affected in all forms. We evaluated the CA of vasculitides patients non-invasively, using magnetic resonance angiography (MRA), and performed viability study using contrast- enhanced MRI (CE-MRI). Twelve pts with MPA, 2 with PAN, 13 with WG and 6 with CSS without any cardiac symptoms, were studied and compared with 13 age- and sex-matched controls and with a control disease-group of 13 pts with rheumatoid arthritis (RA). The maximal diameter of the proximal 1/3 of each coronary vessel was recorded. MRA was performed using a 1.5 T system. Data acquisition was performed with ECG gating in mid-diastole and with the patient free breathing. CE-MRI images were acquired 15 minutes after the IV injection of 0.1 mmol/kg Gd-DTPA using an inversion recovery gradient echo pulse sequence. Coronary artery diameter was found significantly greater in MPA and WG compared to controls. Criteria for ectasia were fullfiled by MPA, but none of WG pts. Coronary vessel diameters were increased in MPA group compared to RA, but there was no difference between RA and WG. In contrary, no coronary ectasia was documented in CSS patients. Evidence of myocardial scar was identified in one MPA and one CSS patient. Coronary ectasia appears as a common finding in asymptomatic vasculitis pts, while necrosis is rare. Magnetic resonance is feasible in various forms of vasculitis and may provide a non invasive means of prevalence determination and treatment guidance. Coronary vessel diameters in patients and controls .