Assessment of right ventricular involvement in patients with anti-MDA5 Ab+ DM: a prospectively observational study with cardiac magnetic resonance imaging

BackgroundAnti-melanoma differentiation-associated gene 5 dermatomyositis (anti-MDA5 Ab+ DM) is characterized by amyopathic DM with interstitial lung disease. Its impact on the right ventricle remains unclear. We aim to evaluate RV involvement in anti-MDA5 Ab+ DM patients using cardiovascular magnet...

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Main Authors: Ling Zhang, Yuli Wang, Jinzhu Dai, Xiaoqi Pu, Anqi Liu, Yifei Ni, Jianping Wang, Jie Du, Yanhong Ren, Xiaoming Shu, Min Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1558800/full
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author Ling Zhang
Yuli Wang
Jinzhu Dai
Xiaoqi Pu
Anqi Liu
Anqi Liu
Yifei Ni
Yifei Ni
Jianping Wang
Jianping Wang
Jie Du
Jie Du
Yanhong Ren
Xiaoming Shu
Min Liu
author_facet Ling Zhang
Yuli Wang
Jinzhu Dai
Xiaoqi Pu
Anqi Liu
Anqi Liu
Yifei Ni
Yifei Ni
Jianping Wang
Jianping Wang
Jie Du
Jie Du
Yanhong Ren
Xiaoming Shu
Min Liu
author_sort Ling Zhang
collection DOAJ
description BackgroundAnti-melanoma differentiation-associated gene 5 dermatomyositis (anti-MDA5 Ab+ DM) is characterized by amyopathic DM with interstitial lung disease. Its impact on the right ventricle remains unclear. We aim to evaluate RV involvement in anti-MDA5 Ab+ DM patients using cardiovascular magnetic resonance (CMR).MethodsThis single-center, prospective cohort study included 43 anti-MDA5 Ab+ DM patients (24 males, mean age = 44.7 ± 11.1 years) and 30 age- and gender-matched healthy controls (18 males, mean age = 44.8 ± 10.4 years). All patients underwent CMR before treatment. RV functional parameters, including ejection fraction (RVEF), end-diastolic/end-systolic remodeling index (RVEDRI/RVESRI), and right ventricular long-axis strain (RV-LAS), and RV and LV T1 and T2 mapping were analyzed. Differences between the two groups were evaluated, and correlations with clinical data were explored.ResultsAnti-MDA5 Ab+ DM patients exhibited a significant decrease in RVEF (45.7 ± 5.9% vs. 52.7 ± 6.6%, P < 0.001) and RV-LAS across all techniques. Increased RVESRI (1.38 ± 0.14 vs. 1.29 ± 0.14, P = 0.031) indicated RV subclinical dysfunction. The RV and LV blood pool T2 ratio was elevated in patients (0.96 ± 0.02 vs. 0.94 ± 0.03, P = 0.007). Patients in the inflammatory marker-positive group exhibited significantly worse RV-LAS compared with the negative group. RV-LASIns/mid negatively correlated with hsTnl levels (r = −0.34, P = 0.026), and ferritin (FER) is moderately positively correlated with RV-LASLVapex/peri (r = 0.487, P < 0.001).ConclusionRV subclinical dysfunction is common in patients with anti-MDA5 Ab+ DM. RV parameters on CMR such as RV-LAS and RVESRI serve as valuable imaging markers for early detection and risk stratification. These findings underscore the importance of routine cardiac evaluation in anti-MDA5 Ab+ DM.
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spelling doaj-art-4fc39310d803441da641c285fc4d26c92025-08-20T02:56:36ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-05-011210.3389/fcvm.2025.15588001558800Assessment of right ventricular involvement in patients with anti-MDA5 Ab+ DM: a prospectively observational study with cardiac magnetic resonance imagingLing Zhang0Yuli Wang1Jinzhu Dai2Xiaoqi Pu3Anqi Liu4Anqi Liu5Yifei Ni6Yifei Ni7Jianping Wang8Jianping Wang9Jie Du10Jie Du11Yanhong Ren12Xiaoming Shu13Min Liu14Department of Radiology, China–Japan Friendship Hospital, Beijing, ChinaDepartment of Radiology, China–Japan Friendship Hospital, Beijing, ChinaDepartment of Radiology, China–Japan Friendship Hospital, Beijing, ChinaDepartment of Radiology, China–Japan Friendship Hospital, Beijing, ChinaDepartment of Radiology, China–Japan Friendship Hospital, Beijing, ChinaDepartment of Radiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiology, China–Japan Friendship Hospital, Beijing, ChinaDepartment of Radiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiology, China–Japan Friendship Hospital, Beijing, ChinaDepartment of Radiology, Capital Medical University, Beijing, ChinaDepartment of Radiology, China–Japan Friendship Hospital, Beijing, ChinaDepartment of Radiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Pulmonary and Critical Care Medicine, China–Japan Friendship Hospital, Beijing, ChinaDepartment of Rheumatology and Immunology, China–Japan Friendship Hospital, Beijing, ChinaDepartment of Radiology, China–Japan Friendship Hospital, Beijing, ChinaBackgroundAnti-melanoma differentiation-associated gene 5 dermatomyositis (anti-MDA5 Ab+ DM) is characterized by amyopathic DM with interstitial lung disease. Its impact on the right ventricle remains unclear. We aim to evaluate RV involvement in anti-MDA5 Ab+ DM patients using cardiovascular magnetic resonance (CMR).MethodsThis single-center, prospective cohort study included 43 anti-MDA5 Ab+ DM patients (24 males, mean age = 44.7 ± 11.1 years) and 30 age- and gender-matched healthy controls (18 males, mean age = 44.8 ± 10.4 years). All patients underwent CMR before treatment. RV functional parameters, including ejection fraction (RVEF), end-diastolic/end-systolic remodeling index (RVEDRI/RVESRI), and right ventricular long-axis strain (RV-LAS), and RV and LV T1 and T2 mapping were analyzed. Differences between the two groups were evaluated, and correlations with clinical data were explored.ResultsAnti-MDA5 Ab+ DM patients exhibited a significant decrease in RVEF (45.7 ± 5.9% vs. 52.7 ± 6.6%, P < 0.001) and RV-LAS across all techniques. Increased RVESRI (1.38 ± 0.14 vs. 1.29 ± 0.14, P = 0.031) indicated RV subclinical dysfunction. The RV and LV blood pool T2 ratio was elevated in patients (0.96 ± 0.02 vs. 0.94 ± 0.03, P = 0.007). Patients in the inflammatory marker-positive group exhibited significantly worse RV-LAS compared with the negative group. RV-LASIns/mid negatively correlated with hsTnl levels (r = −0.34, P = 0.026), and ferritin (FER) is moderately positively correlated with RV-LASLVapex/peri (r = 0.487, P < 0.001).ConclusionRV subclinical dysfunction is common in patients with anti-MDA5 Ab+ DM. RV parameters on CMR such as RV-LAS and RVESRI serve as valuable imaging markers for early detection and risk stratification. These findings underscore the importance of routine cardiac evaluation in anti-MDA5 Ab+ DM.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1558800/fullMDA5+ DMright ventricular functionright ventricular long-axis strain (RV-LAS)end-diastolic remodeling indexT1 mappingT2 mapping
spellingShingle Ling Zhang
Yuli Wang
Jinzhu Dai
Xiaoqi Pu
Anqi Liu
Anqi Liu
Yifei Ni
Yifei Ni
Jianping Wang
Jianping Wang
Jie Du
Jie Du
Yanhong Ren
Xiaoming Shu
Min Liu
Assessment of right ventricular involvement in patients with anti-MDA5 Ab+ DM: a prospectively observational study with cardiac magnetic resonance imaging
Frontiers in Cardiovascular Medicine
MDA5+ DM
right ventricular function
right ventricular long-axis strain (RV-LAS)
end-diastolic remodeling index
T1 mapping
T2 mapping
title Assessment of right ventricular involvement in patients with anti-MDA5 Ab+ DM: a prospectively observational study with cardiac magnetic resonance imaging
title_full Assessment of right ventricular involvement in patients with anti-MDA5 Ab+ DM: a prospectively observational study with cardiac magnetic resonance imaging
title_fullStr Assessment of right ventricular involvement in patients with anti-MDA5 Ab+ DM: a prospectively observational study with cardiac magnetic resonance imaging
title_full_unstemmed Assessment of right ventricular involvement in patients with anti-MDA5 Ab+ DM: a prospectively observational study with cardiac magnetic resonance imaging
title_short Assessment of right ventricular involvement in patients with anti-MDA5 Ab+ DM: a prospectively observational study with cardiac magnetic resonance imaging
title_sort assessment of right ventricular involvement in patients with anti mda5 ab dm a prospectively observational study with cardiac magnetic resonance imaging
topic MDA5+ DM
right ventricular function
right ventricular long-axis strain (RV-LAS)
end-diastolic remodeling index
T1 mapping
T2 mapping
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1558800/full
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