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Echocardiography, however, detects cardiac decompensation. This study was undertaken to investigate the use of cardiac\n                      <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>\n                      to explore early warning signs of silent cardiac involvement and determine treatment timing in\n                      <jats:styled-content style=\"fixed-case\">SLE<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Clinical assessment and cardiac\n                      <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>\n                      studies were performed in 50 drug\u2010naive patients with new\u2010onset\n                      <jats:styled-content style=\"fixed-case\">SLE<\/jats:styled-content>\n                      , 60 patients with longstanding\n                      <jats:styled-content style=\"fixed-case\">SLE<\/jats:styled-content>\n                      , and 50 healthy subjects in a 3\u2010center prospective study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Analysis of cardiac enzymes, the presence and size of regional myocardial fibrosis as indicated by late gadolinium enhancement, strain changes, and biventricular ejection fraction did not indicate cardiac impairment in the patients with new\u2010onset\n                      <jats:styled-content style=\"fixed-case\">SLE<\/jats:styled-content>\n                      . Native myocardial T1 and extracellular volume (\n                      <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content>\n                      ), which are extracellular matrix indices, were elevated in the patients with new\u2010onset\n                      <jats:styled-content style=\"fixed-case\">SLE<\/jats:styled-content>\n                      (mean \u00b1 SD 1,369 \u00b1 79 msec versus 1,092 \u00b1 57 msec in the control group for native T1; 32 \u00b1 5% versus 24 \u00b1 3% in the control group for\n                      <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content>\n                      ;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001 for both). The elevation was independent of\n                      <jats:styled-content style=\"fixed-case\">SLE<\/jats:styled-content>\n                      disease activity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This is the first study to indicate that drug\u2010naive patients with new\u2010onset\n                      <jats:styled-content style=\"fixed-case\">SLE<\/jats:styled-content>\n                      , even those with inactive disease, are likely to have silent cardiac impairment. Structural and functional changes in the myocardium are related to\n                      <jats:styled-content style=\"fixed-case\">SLE<\/jats:styled-content>\n                      disease stage; this finding indicates the value of early detection of myocardial involvement. Native myocardial T1 values and\n                      <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content>\n                      , rather than currently used clinical rheumatic and cardiac indices, could serve as early detection markers of myocardial injury before the presence of visual fibrosis and functional decompensation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.40671","type":"journal-article","created":{"date-parts":[[2018,8,3]],"date-time":"2018-08-03T19:27:38Z","timestamp":1533324458000},"page":"2014-2024","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Early Detection of Silent Myocardial Impairment in Drug\u2010Naive Patients With New\u2010Onset Systemic Lupus Erythematosus"],"prefix":"10.1002","volume":"70","author":[{"given":"Qiang","family":"Guo","sequence":"first","affiliation":[{"name":"Renji Hospital and Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian\u2010Ming","family":"Wu","sequence":"additional","affiliation":[{"name":"Renji Hospital and Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi","family":"Wang","sequence":"additional","affiliation":[{"name":"Renji Hospital and Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Yan","family":"Shen","sequence":"additional","affiliation":[{"name":"Huashan Hospital Baoshan Branch and Shanghai Medical College Fudan University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Su","sequence":"additional","affiliation":[{"name":"Renji Hospital and Shanghai Jiao Tong University School of Medicine Shanghai 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