The Heart in Inflammatory Myopathies

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Key points

  • Systemic autoimmune diseases are becoming increasingly linked to accelerated risks of cardiovascular disease and events, and the idiopathic inflammatory myopathies (IIM) are not an exception to this growing pattern.

  • Traditional risk factors for coronary artery disease, such as hypertension and hyperlipidemia, are associated with cardiovascular disease and events in patients with IIM.

  • IIM patients with cardiac involvement are at increased risk for overall mortality when compared with IIM patients

Methods

Articles were searched on pubmed.gov for the keywords of “Myositis” or “IIM” or “Myopathy” with the boolean operator AND followed by “Cardiovascular Disease” or “Cardiac” or “Cardiomyopathy” and appropriate articles were chosen. Only articles in English published after 2005 were chosen for inclusion if they were deemed to be appropriate for the current review as determined by the authors. In addition, Web searches for online textbooks in rheumatology and IIM were included besides the initial

Cardiomyopathies: Myocarditis

Cardiomyopathies can be defined as myocardial disorders in which the heart muscle is structurally and functionally abnormal in the absence of coronary artery disease (CAD), hypertension, valvular heart disease, and congenital heart disease.6 Cardiac magnetic resonance imaging (CMR) provides 3-dimensional data on cardiac anatomy, function, tissue characterization, coronary and microvascular perfusion, and valvular disease without ionizing radiation. Several case reports and case series have

Summary

Systemic autoimmune diseases are becoming increasingly linked to accelerated risks of cardiovascular disease and events. What is apparent from the above review is that the IIM are not an exception to this growing pattern. Although not always clinically apparent, there seems to be a large percentage of patients who have subclinical CV involvement. Many of the traditional risk factors for CAD, such as hypertension and hyperlipidemia, are associated with developing cardiac involvement in patients

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      So far, there are few studies evaluating electrocardiographic changes in patients with DM and PM; and, when present, these are limited to a small number of cases and/or in the absence of a control group,7,9,10,12,13 differently of the present study. ECG changes in idiopathic inflammatory myopathies occur in 33–72%.3–5,7–13 Our data show that LVH was significantly present in patients with DM and PM compared to the control group.

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