Cardiac involvement in systemic rheumatic diseases: An update

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• 作者：Piercarlo Sarzi-Puttini ; Fabiola Atzeni ; Roberto Gerli ; Elena Bartoloni ; Andrea Doria ; Tatiana Barskova ; Marco Matucci-Cerinic ; Simona Sitia ; Livio Tomasoni ; Maurizio Turiel
• 关键词：Atherosclerosis ; Rheumatoid arthritis ; Systemic lupus erythematosus ; Systemic sclerosis ; Heart ; Autoimmune diseases
• 刊名：Autoimmunity Reviews
• 出版年：2010
• 出版时间：October 2010
• 年：2010
• 卷：9
• 期：12
• 页码：849-852
• 全文大小：175 K

文摘

The high rates of cardiovascular (CV) mortality and morbidity observed in patients with systemic autoimmune diseases (SADs) cannot be fully explained by traditional atherosclerosis risk factors as standard therapy (i.e. corticosteroids and methotrexate), cytokines and disease activity may all contribute to accelerated atherosclerosis. There is considerable evidence showing that chronic inflammation and immune dysregulation play a pathogenetic role in the development of atherosclerosis in patients with SADs. Chronic inflammation, accelerated atherosclerosis and functional abnormalities of the endothelium suggest that subclinical CV involvement begins soon after the onset of the disease and progresses with disease duration. All cardiac structures may be affected during the course of SADs (valves, the conduction system, the myocardium, endocardium and pericardium, and coronary arteries), and the cardiac complications have a variety of clinical manifestations. As these are all associated with an unfavourable prognosis, it is essential to detect subclinical cardiac involvement in asymptomatic SAD patients, and begin adequate management and treatment early.