Predictors of cardiac involvement in idiopathic inflammatory myopathies

Abstract

ObjectivesIdiopathic inflammatory myopathies (IIM) are a group of rare disorders that can affect the heart. This work aimed to find predictors of cardiac involvement in IIM.MethodsMulticenter, open cohort study, including patients registered in the IIM module of the Rheumatic Diseases Portuguese Register (Reuma.pt/Myositis) until January 2022. Patients without cardiac involvement information were excluded. Myo(peri)carditis, dilated cardiomyopathy, conduction abnormalities, and/or premature coronary artery disease were considered.Results230 patients were included, 163 (70.9%) of whom were females. Thirteen patients (5.7%) had cardiac involvement. Compared with IIM patients without cardiac involvement, these patients had a lower bilateral manual muscle testing score (MMT) at the peak of muscle weakness [108.0 ± 55.0 vs 147.5 ± 22.0, p=0.008] and more frequently had oesophageal [6/12 (50.0%) vs 33/207 (15.9%), p=0.009] and lung [10/13 (76.9%) vs 68/216 (31.5%), p=0.001] involvements. Anti-SRP antibodies were more commonly identified in patients with cardiac involvement [3/11 (27.3%) vs 9/174 (5.2%), p=0.026]. In the multivariate analysis, positivity for anti-SRP antibodies (OR 104.3, 95% CI: 2.5-4277.8, p=0.014) was a predictor of cardiac involvement, regardless of sex, ethnicity, age at diagnosis, and lung involvement. Sensitivity analysis confirmed these results.ConclusionAnti-SRP antibodies were predictors of cardiac involvement in our cohort of IIM patients, irrespective of demographical characteristics and lung involvement. We suggest considering frequent screening for heart involvement in anti-SRP-positive IIM patients.

Juvenile Dermatomyositis und andere idiopathische inflammatorische Myopathien des Kindesalters

“…12-15 %) sind mögliche kardiale Manifestationen [22]. Besonders bei der Anti-SRP-assoziierten IMNM kommt es zur Herzbeteiligung [23]. Das Risiko für atherosklerotische Veränderungen der Koronarien ist deutlich höher als in der Allgemeinbevölkerung [24].…”

“…Im Kindesalter ist eine Assoziation mit einer IIM äußerst selten und ebenfalls mit einem IMNM-Muster verknüpft. Bei der Anti-SRP-assoziierten IMNM besteht vermehrt eine kardiale Beteiligung 23 .…”

“…Im Kindesalter ist eine Assoziation mit einer IIM äußerst selten und ebenfalls mit einem IMNM-Muster verknüpft. Bei der Anti-SRP-assoziierten IMNM besteht vermehrt eine kardiale Beteiligung[23].Muskelenzyme müssen nicht im selben Ausmaß erhöht sein. Unter Therapie bessern sich die Enzymwerte meist.…”