Cardiac involvement in mixed connective tissue disease: A systematic review

Ungprasert, Patompong; Wannarong, Thapat; Panichsillapakit, Theppharit; Cheungpasitporn, Wisit; Thongprayoon, Charat; Ahmed, Saeed; Raddatz, Donald A.

doi:10.1016/j.ijcard.2013.12.079

Cited by 61 publications

(43 citation statements)

References 15 publications

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“…Data from studies on the prevalence of cardiovascular (CV) involvement have not been consistent due to variabilities in the detection methods (diagnostic sensitivities of different echocardiographic techniques, type of cardiac abnormalities, diagnostic criteria and frequency of examinations), patient-related factors (age, disease severity, chronicity, duration of follow-up and background therapy) and lack of a gold standard for confirmation of observed abnormalities [24,25]. Additionally, the diagnostic capability of novel echocardiographic modalities has allowed the detection of early subclinical cardiac involvement such as diastolic dysfunction and coronary microvascular dysfunction (CMD).…”

Section: Introductionmentioning

confidence: 99%

Echocardiography in the Assessment of Patients with Rheumatologic Diseases

Al-Mohaissen

Chan

2016

Curr Cardiol Rep

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Cardiovascular disease is an important extra-articular manifestation of rheumatologic diseases leading to considerable mortality and morbidity. Echocardiography emerges as a useful non-invasive technique for the screening and evaluation of cardiac involvement in these patients. With the technological advancement in echocardiographic techniques, we have gained a greater appreciation of the prevalence and nature of the cardiac involvement in these patients, as detection of subclinical disease is increasingly feasible. This review discusses cardiac involvement in patients with rheumatoid arthritis, systemic lupus erythematosus, anti-phospholipid antibody syndrome, systemic sclerosis and ankylosing spondylitis, and the role of different echocardiographic modalities in their evaluation.

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Section: Introductionmentioning

confidence: 99%

Echocardiography in the Assessment of Patients with Rheumatologic Diseases

Al-Mohaissen

Chan

2016

Curr Cardiol Rep

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“…6 In three prospective studies with 13 -15 years of followup, MCTD patients had an overall mortality rate of 10.4% and 20% of these deaths were directly attributable to cardiac causes. 7 Vasculitis has been mentioned in MCTD and it often correlates with disease severity and portends poorer prognosis. 3,4 Only one case of such a severe form of vasculitis causing tissue necrosis amounting to necrotising fasciitis has been reported.…”

Section: Managementmentioning

confidence: 99%

McTd With Large Vasculitic Ulcers- A Therapeutic Dilemma

Farande¹,

Petkar²,

Khandge³

2017

jemds

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HOW TO CITE THIS ARTICLE:Farande PV, Petkar S, Khandge A. MCTD with large vasculitic ulcers-a therapeutic dilemma. J. Evolution Med. Dent. Sci. 2017;6(83):5825-5827, DOI: 10.14260/jemds/2017/1265 PRESENTATION OF CASEA 37 years old female, a homemaker, residing in Navi Mumbai, came with chief complaints of multiple painful, reddish black skin lesions with blisters since 2 days, fever since 15 days, ulcer over fingertips since 3 months, tightening of skin over face since 3 months.Patient was apparently alright about 3 months before when she first presented to us with complaints of bluish discoloration of her fingers on exposure to cold. On rewarming, the fingers used to become normal. This was followed by development of small ulcers over the fingertips, which later healed with stellate scars. About 3 months ago, she developed pain in the knee joints. The pain subsided temporarily by the analgesics prescribed by the local practitioner. She also developed swelling of hands and feet and tightening of her facial skin. About 15 days ago, she developed fever. It was of high grade and continuous type, subsiding temporarily with antipyretics. After a few days following the onset of fever she developed painful, reddishblack skin discoloration of skin over the left hand dorsum, right elbow and forearm and the right calf area. The painful discoloration rapidly increased in size and developed reddish fluid filled blisters. There was history of decreased appetite and weight loss. There was no history of photosensitivity, difficulty in swallowing, breathing or other systemic involvement. There was no history suggestive of any neurological or musculoskeletal impairment and urinary bladder disturbance. Past history was not significant. There was no history of drug allergy, medical or surgical illness. Menstrual history -3/28 days regular menstrual cycle. Attained menarche at the age of 17 years of age. Obstetric history-She has three children, all were full-term normal deliveries without any complications. She did not have any history of abortions. General ExaminationPatient was conscious, well-oriented to time, place and person. She was febrile. Her vitals were normal. She had moderate pallor and oedema of hands and both feet. Cutaneous examination revealed multiple areas of cutaneous necrosis in the form of indurated purpuric red skin with multiple haemorrhagic blisters.

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“…CTD associated pulmonary arterial hypertension represents 25% of WHO Group 1 pulmonary hypertension . Cardiac disease has been shown to account for 20% of mortality among patients with CTD . Cardiac abnormalities can stem from pulmonary arterial hypertension or primary cardiac disease, including myocarditis, autoimmune inflammation, and scarring resulting in restrictive cardiomyopathy.…”

Section: Introductionmentioning

confidence: 99%

Heart‐lung transplantation: A viable option for connective tissue diseases

Stern

Selby

Kolaitis

et al. 2020

Clinical Transplantation

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Background While lung transplantation (LTx) has been effective for connective tissue disease (CTD) patients with pulmonary involvement, outcomes for heart‐lung transplantation (HLTx) are less defined. The aim of this study is to evaluate HLTx in CTD patients utilizing the UNOS database. Methods HLTx patients with CTD (HLTx‐CTD) were compared to both LTx patients with CTD (LTx‐CTD) and HLTx patients with all other indications (HLTx‐OI) from 1999 to 2018. Primary outcome was 1‐ and 5‐year graft survival. Secondary outcomes included freedom from first‐year rejection and outcomes prior to transplant discharge. Results 1143/29 323 adults received first‐time HLTx or LTx for CTD. Seventeen were HLTx‐CTD (3.3% of total HLTx) and 1126 were LTx‐CTD (3.9% of total LTx). There were 492 HLTx‐OI. Transplant hemodynamic values including cardiac output, pulmonary capillary wedge pressure, and calculated pulmonary vascular resistance were significantly worse for HLTx‐CTD vs LTx‐CTD (4.2 vs 5.4 L/min, P = .005; 14 vs 10 mm Hg, P = .009; 439 vs 267 dynes, P = .007, respectively). Cardiac status 1 was more common for HLTx‐CTD vs HLTx‐OI (94% vs 56%, P < .001). HLTx‐CTD 1 and 5‐year graft survival was similar compared to LTx‐CTD and HLTx‐OI. Conclusion HLTx‐CTD is a valid option for carefully selected patients with CTD cardiac and pulmonary involvement with similar morbidity and mortality compared to LTx‐CTD and HLTx‐OI.

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Cardiac involvement in mixed connective tissue disease: A systematic review

Cited by 61 publications

References 15 publications

Echocardiography in the Assessment of Patients with Rheumatologic Diseases

Echocardiography in the Assessment of Patients with Rheumatologic Diseases

McTd With Large Vasculitic Ulcers- A Therapeutic Dilemma

Heart‐lung transplantation: A viable option for connective tissue diseases

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