{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:25:06Z","timestamp":1790623506247,"version":"4.1.0"},"reference-count":34,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T00:00:00Z","timestamp":1646438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background. Patients with inflammatory joint diseases (IJD) are more likely to develop cardiovascular disease compared with the general population. We hypothesized that cardiovascular magnetic resonance (CMR) could identify cardiac abnormalities in patients with IJD and atypical symptoms unexplained by routine clinical evaluation. Patients-Methods. A total of 51 consecutive patients with IJD (32 with rheumatoid arthritis, 10 with ankylosing spondylitis, and 9 with psoriatic arthritis) and normal clinical, electrocardiographic and echocardiographic workups, were referred for CMR evaluation due to atypical chest pain, shortness of breath, and\/or palpitations. Their CMR findings were compared with those of 40 non-IJD controls who were referred for the same reason. All participants were examined using either a 1.5 T or 3.0 T CMR system. For T1\/T2 mapping, comparisons were performed separately for each field strength. Results. Biventricular systolic function was similar between groups. In total, 25 (49%) patients with IJD vs. 0 (0%) controls had replacement-type myocardial fibrosis (p &lt; 0.001). The T2 signal ratio, early\/late gadolinium enhancement, and extracellular volume fraction were significantly higher in the IJD group. Native T1 mapping was significantly higher in patients with IJD independent of the MRI field strength (p &lt; 0.001 for both). T2 mapping was significantly higher in patients with IJD compared with controls only in those examined using a 1.5 T MR system\u201452.0 (50.0, 55.0) vs. 37.0 (33.5, 39.5), p &lt; 0.001. Conclusions. In patients with IJD and a mismatch between cardiac symptoms and routine non-invasive evaluation, CMR uniquely identified a significant proportion of patients with myocardial inflammation. A CMR examination should be considered in patients with IJD in similar clinical settings.<\/jats:p>","DOI":"10.3390\/jcm11051428","type":"journal-article","created":{"date-parts":[[2022,3,6]],"date-time":"2022-03-06T20:38:16Z","timestamp":1646599096000},"page":"1428","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cardiovascular Magnetic Resonance Detects Inflammatory Cardiomyopathy in Symptomatic Patients with Inflammatory Joint Diseases and a Normal Routine Workup"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8192-6670","authenticated-orcid":false,"given":"George","family":"Markousis-Mavrogenis","sequence":"first","affiliation":[{"name":"Onassis Cardiac Surgery Center, 17674 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Bonou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Laikon Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Vartela","sequence":"additional","affiliation":[{"name":"Onassis Cardiac Surgery Center, 17674 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genovefa","family":"Kolovou","sequence":"additional","affiliation":[{"name":"Onassis Cardiac Surgery Center, 17674 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4280-9193","authenticated-orcid":false,"given":"Aliki","family":"Venetsanopoulou","sequence":"additional","affiliation":[{"name":"Rheumatology Department, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodora","family":"Markatseli","sequence":"additional","affiliation":[{"name":"Rheumatology Department, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4104-2878","authenticated-orcid":false,"given":"Anastasia","family":"Skalkou","sequence":"additional","affiliation":[{"name":"Rheumatology Department, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoi","family":"Tziortzioti","sequence":"additional","affiliation":[{"name":"Rheumatology Department, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paraskevi","family":"Voulgari","sequence":"additional","affiliation":[{"name":"Rheumatology Department, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie I.","family":"Mavrogeni","sequence":"additional","affiliation":[{"name":"Onassis Cardiac Surgery Center, 17674 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1002\/art.20855","article-title":"The Risk of Congestive Heart Failure in Rheumatoid Arthritis: A Population-Based Study over 46 Years","volume":"52","author":"Nicola","year":"2005","journal-title":"Arthritis Rheum."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.3899\/jrheum.100979","article-title":"The Influence of Rheumatoid Arthritis Disease Characteristics on Heart Failure","volume":"38","author":"Myasoedova","year":"2011","journal-title":"J. Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3039","DOI":"10.1002\/art.21349","article-title":"How Much of the Increased Incidence of Heart Failure in Rheumatoid Arthritis Is Attributable to Traditional Cardiovascular Risk Factors and Ischemic Heart Disease?","volume":"52","author":"Crowson","year":"2005","journal-title":"Arthritis Rheum."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e12915","DOI":"10.1111\/eci.12915","article-title":"Development of Heart Failure in Patients with Rheumatoid Arthritis: A Danish Population-Based Study","volume":"48","author":"Ellingsen","year":"2018","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1016\/j.jacc.2016.12.033","article-title":"Association Between Rheumatoid Arthritis and Risk of Ischemic and Nonischemic Heart Failure","volume":"69","author":"Mantel","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e014661","DOI":"10.1161\/JAHA.119.014661","article-title":"Heart Failure Risk Associated With Rheumatoid Arthritis-Related Chronic Inflammation","volume":"9","author":"Ahlers","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e8180","DOI":"10.1097\/MD.0000000000008180","article-title":"Subclinical Atherosclerosis and History of Cardiovascular Events in Italian Patients with Rheumatoid Arthritis: Results from a Cross-Sectional, Multicenter GIRRCS (Gruppo Italiano Di Ricerca in Reumatologia Clinica e Sperimentale) Study","volume":"96","author":"Ruscitti","year":"2017","journal-title":"Medicine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"174","DOI":"10.31053\/1853.0605.v76.n3.21610","article-title":"Subclinical Markers of Atherosclerosis and Cardiovascular Risk Factors in Early Arthritis","volume":"76","author":"Gobbi","year":"2019","journal-title":"Rev. Fac. Cienc. Med. Cordoba Argent."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.atherosclerosis.2018.03.004","article-title":"Subclinical Impairment of Myocardial and Endothelial Functionality in Very Early Psoriatic and Rheumatoid Arthritis Patients: Association with Vitamin D and Inflammation","volume":"271","author":"Gullo","year":"2018","journal-title":"Atherosclerosis"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.ijcard.2018.02.027","article-title":"The Prognostic Value of High Sensitivity C-Reactive Protein in a Multi-Ethnic Population After More Than 10 Years of Follow-Up: The Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"264","author":"Miedema","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1002\/acr.23138","article-title":"Magnetic Resonance Imaging-Detected Myocardial Inflammation and Fibrosis in Rheumatoid Arthritis: Associations With Disease Characteristics and N-Terminal Pro-Brain Natriuretic Peptide Levels","volume":"69","author":"Kobayashi","year":"2017","journal-title":"Arthritis Care Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.hjc.2018.01.008","article-title":"Cardiovascular Magnetic Resonance Characterization of Myocardial and Vascular Function in Rheumatoid Arthritis Patients","volume":"60","author":"Ntusi","year":"2019","journal-title":"Hell. J. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4333","DOI":"10.1016\/j.ijcard.2013.05.085","article-title":"Imaging Patterns of Heart Failure in Rheumatoid Arthritis Evaluated by Cardiovascular Magnetic Resonance","volume":"168","author":"Mavrogeni","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1016\/j.jacc.2009.02.007","article-title":"Cardiovascular Magnetic Resonance in Myocarditis: A JACC White Paper","volume":"53","author":"Friedrich","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.ijcard.2016.04.158","article-title":"Cardiovascular Magnetic Resonance in Rheumatology: Current Status and Recommendations for Use","volume":"217","author":"Mavrogeni","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1532-429X-14-42","article-title":"Non-Contrast T1-Mapping Detects Acute Myocardial Edema with High Diagnostic Accuracy: A Comparison to T2-Weighted Cardiovascular Magnetic Resonance","volume":"14","author":"Ferreira","year":"2012","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/HCO.0b013e32835f5a2b","article-title":"Noninvasive Imaging of Myocardial Extracellular Matrix for Assessment of Fibrosis","volume":"28","author":"Won","year":"2013","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1159\/000478901","article-title":"T1 and T2 Mapping in Cardiology: \u201cMapping the Obscure Object of Desire\u201d","volume":"138","author":"Mavrogeni","year":"2017","journal-title":"Cardiology"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Markousis-Mavrogenis, G., Koutsogeorgopoulou, L., Katsifis, G., Dimitroulas, T., Kolovou, G., Kitas, G.D., Sfikakis, P.P., and Mavrogeni, S.I. (2020). The Double-Edged Sword of T1-Mapping in Systemic Sclerosis\u2014A Comparison with Infectious Myocarditis Using Cardiovascular Magnetic Resonance. Diagnostics, 10.","DOI":"10.3390\/diagnostics10050335"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jcmg.2017.01.025","article-title":"CMR-Derived Extracellular Volume Fraction as a Marker for Myocardial Fibrosis: The Importance of Coexisting Myocardial Inflammation","volume":"11","author":"Lurz","year":"2018","journal-title":"JACC. Cardiovasc. Imaging"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.ijcard.2018.10.067","article-title":"Cardiovascular Magnetic Resonance Imaging Pattern in Patients with Autoimmune Rheumatic Diseases and Ventricular Tachycardia with Preserved Ejection Fraction","volume":"284","author":"Mavrogeni","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.jcmg.2014.12.025","article-title":"Diffuse Myocardial Fibrosis and Inflammation in Rheumatoid Arthritis: Insights From CMR T1 Mapping","volume":"8","author":"Ntusi","year":"2015","journal-title":"JACC. Cardiovasc. Imaging"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4639","DOI":"10.1007\/s00330-017-4838-4","article-title":"Advanced Myocardial Tissue Characterisation by a Multi-Component CMR Protocol in Patients with Rheumatoid Arthritis","volume":"27","author":"Greulich","year":"2017","journal-title":"Eur. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.ijcard.2018.06.099","article-title":"Anti-TNF Modulation Reduces Myocardial Inflammation and Improves Cardiovascular Function in Systemic Rheumatic Diseases","volume":"270","author":"Ntusi","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1136\/heartjnl-2016-310667","article-title":"Insights into Cardiac Involvement in Ankylosing Spondylitis from Cardiovascular Magnetic Resonance","volume":"103","author":"Biesbroek","year":"2017","journal-title":"Heart"},{"key":"ref_26","first-page":"413","article-title":"The Use of Inflammatory Laboratory Tests in Rheumatology","volume":"49","author":"Neto","year":"2009","journal-title":"Rev. Bras. De Reumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1161\/HYPERTENSIONAHA.118.11463","article-title":"Association Between Inflammatory Markers and Myocardial Fibrosis","volume":"72","author":"Marques","year":"2018","journal-title":"Hypertension"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1136\/annrheumdis-2013-203314","article-title":"Evaluation of myocardial function in patients with rheumatoid arthritis using strain imaging by speckle-tracking echocardiography","volume":"73","author":"Fine","year":"2014","journal-title":"Ann. Rheum. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jsha.2018.10.001","article-title":"2-D speckle-tracking assessment of left and right ventricular function in rheumatoid arthritis patients with and without disease activity","volume":"31","author":"Naseem","year":"2019","journal-title":"J. Saudi Hear. Assoc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1080\/1354750X.2017.1279218","article-title":"CRP Velocity and Short-Term Mortality in ST Segment Elevation Myocardial Infarction","volume":"22","author":"Milwidsky","year":"2017","journal-title":"Biomarkers"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ejim.2019.02.018","article-title":"Rheumatoid Arthritis Patients Have Higher Prevalence and Burden of Asymptomatic Coronary Artery Disease Assessed by Coronary Computed Tomography: A Systematic Literature Review and Meta-Analysis","volume":"62","author":"Hansen","year":"2019","journal-title":"Eur. J. Intern. Med."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Mavrogeni, S.I., Markousis-Mavrogenis, G., Karapanagiotou, O., Toutouzas, K., Argyriou, P., Velitsista, S., Kanoupakis, G., Apostolou, D., Hautemann, D., and Sfikakis, P.P. (2019). Silent Myocardial Perfusion Abnormalities Detected by Stress Cardiovascular Magnetic Resonance in Antiphospholipid Syndrome: A Case-Control Study. J. Clin. Med., 8.","DOI":"10.3390\/jcm8071084"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1002\/art.27349","article-title":"Left Ventricular Structure and Function in Patients with Rheumatoid Arthritis, as Assessed by Cardiac Magnetic Resonance Imaging","volume":"62","author":"Giles","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1002\/art.24148","article-title":"Independent Association of Rheumatoid Arthritis with Increased Left Ventricular Mass but Not with Reduced Ejection Fraction","volume":"60","author":"Rudominer","year":"2009","journal-title":"Arthritis Rheum."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/5\/1428\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:32:33Z","timestamp":1760135553000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/5\/1428"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,5]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["jcm11051428"],"URL":"https:\/\/doi.org\/10.3390\/jcm11051428","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,5]]}}}