Clinical cardiac involvement in idiopathic inflammatory myopathies: A systematic review

Gupta, Raghav; Wayangankar, Siddharth A.; Targoff, Ira N.; Hennebry, Thomas A.

doi:10.1016/j.ijcard.2010.08.013

Cited by 109 publications

(118 citation statements)

References 44 publications

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“…The exact molecular and cellular mechanisms of the LV diastolic dysfunction have not yet been clarified, but these diastolic abnormalities during the followup period suggest intrinsic myocardial manifestation 9 . Gupta, et al suggested the role of myocardial fibrosis and recurrent myocarditis 25 . Further, vascular factors such as vasculitis, intima hyperplasia, or sclerosis of the tunica media of the coronary arteries may play a role in PM 7 .…”

Section: Journal Of Rheumatologymentioning

confidence: 99%

“…These alterations appear to be reversible in patients with specific therapy (high-dose steroid and immunosuppression), according to both our observations with echocardiography and the cardiac MRI results of Allanore, et al, who detected markedly reduced myocardial MRI contrast enhancement as a consequence of specific therapy 36 . If, however, early echocardiographic changes show progression, then recurrent inflammation, myocardial fibrosis 8,25 , and consequential diastolic dysfunction occur 9,10,11 . Less frequently, development of severe left or right heart systolic dysfunction indicates irreversible changes, with occurrence of severe cardiovascular pathologies (acute fulminant myocarditis, cardiomyopathy, ruptured mitral chordae tendineae, or acute right heart failure) and affecting cardiac morbidity and mortality of patients with PM/DM.…”

Section: Journal Of Rheumatologymentioning

confidence: 99%

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Echocardiographic Abnormalities in New-onset Polymyositis/dermatomyositis

Peter

Balogh²,

Szilágyi³

et al. 2014

J Rheumatol

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Section: Journal Of Rheumatologymentioning

confidence: 99%

Section: Journal Of Rheumatologymentioning

confidence: 99%

Echocardiographic Abnormalities in New-onset Polymyositis/dermatomyositis

Peter

Balogh²,

Szilágyi³

et al. 2014

J Rheumatol

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“…Processes affecting the heart in IIM include coronary heart disease and primary myocardial disease (7). However, few studies have distinguished between these distinct entities.…”

Section: Introductionmentioning

confidence: 99%

Cardiac Abnormalities in Adult Patients With Polymyositis or Dermatomyositis as Assessed by Noninvasive Modalities

Diederichsen

Simonsen

Diederichsen

et al. 2016

Arthritis Care & Research

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Objective. Cardiac events are a major cause of death in patients with idiopathic inflammatory myopathies. The study objective was in a controlled setting to describe cardiac abnormalities by noninvasive methods in a cohort of patients with polymyositis (PM) or dermatomyositis (DM) and to identify predictors for cardiac dysfunction. Methods. In a cross-sectional study, 76 patients with PM/DM and 48 matched healthy controls (HCs) were assessed by serum levels of cardiac troponin I, electrocardiography, Holter monitoring, echocardiography with tissue Doppler imaging, and quantitative cardiac Results. Compared to HCs, patients with PM/DM more frequently had left ventricular diastolic dysfunction (LVDD) (12% versus 0%; P 5 0.02) and longer QRS and QT intervals (P 5 0.007 and P < 0.0001, respectively). In multivariate analysis, factors associated with LVDD were age (P 5 0.001), disease duration (P 5 0.004), presence of myositis-specific or -associated autoantibodies (P 5 0.05), and high cardiac 99m Tc-PYP uptake (P 5 0.006). In multivariate analysis of the pooled data for patients and HCs, a diagnosis of PM/DM (P < 0.0001) was associated with LVDD. Conclusion. Patients with PM or DM had an increased prevalence of cardiac abnormalities compared to HCs. LVDD was a common occurrence in PM/DM patients and correlated to disease duration. In addition, the association of LVDD with myositis-specific or -associated autoantibodies and high cardiac 99m Tc-PYP uptake supports the notion of underlying autoimmunity and myocardial inflammation in patients with PM/DM.

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“…Indeed, ILD is the most frequent manifestation of ASS and some patients with ASS may present signs of SSc [1,2,14], which often causes PAH or PH-ILD [7,8,15,16]. Conversely, specific left heart dysfunction seems rare in myositis [17].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary hypertension in antisynthetase syndrome: prevalence, aetiology and survival

et al. 2013

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Antisynthetase syndrome is characterised by the association of interstitial lung disease and myositis with different anti-tRNA-synthetase antibodies. The occurrence, aetiology and prognosis of pulmonary hypertension have not yet been evaluated.Among 203 consecutive patients, transthoracic echocardiogram and right heart catheterisation results were retrospectively analysed in the light of clinico-biological, morphological and functional parameters. Definitions of pulmonary hypertension were based on the European Society of Cardiology/European Respiratory Society 2009 guidelines, with severe pulmonary hypertension being defined by a mean pulmonary arterial pressure .35 mmHg.Pulmonary hypertension was suspected by transthoracic echocardiogram in 47 (23.2%) cases, corresponding to pulmonary hypertension ''possible'' (n527, 13.3%) or ''likely'' (n520, 9.9%). Right heart catheterisation was performed in 21 patients, excluding pulmonary hypertension in five and confirming pre-capillary pulmonary hypertension in 16 (7.9%). Although related to interstitial lung disease in all cases, pre-capillary pulmonary hypertension was severe in 13 (81.3%) patients (mean¡SD pulmonary arterial pressure 46¡9 mmHg), frequently associated with low cardiac index (mean¡SD 2.3¡0.8 L?min -1 ?m -2 ) and high forced vital capacity/diffusing capacity of the lung for carbon monoxide ratio (2.5¡0.6). Pulmonary hypertension was significantly associated with a lower survival rate (p,0.001), with a 3-year survival rate of 58%.The occurrence of pulmonary hypertension in antisynthetase syndrome is significant and dramatically worsens the prognosis. Although systematically associated with interstitial lung disease, pulmonary hypertension was usually severe, suggesting a specific pulmonary vascular involvement. @ERSpublications PH in antisynthetase syndrome significantly worsens the prognosis, suggesting a specific pulmonary vascular involvement

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Clinical cardiac involvement in idiopathic inflammatory myopathies: A systematic review

Cited by 109 publications

References 44 publications

Echocardiographic Abnormalities in New-onset Polymyositis/dermatomyositis

Echocardiographic Abnormalities in New-onset Polymyositis/dermatomyositis

Cardiac Abnormalities in Adult Patients With Polymyositis or Dermatomyositis as Assessed by Noninvasive Modalities

Pulmonary hypertension in antisynthetase syndrome: prevalence, aetiology and survival

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