Lu Zhang1, Guo-chun Wang, Li Ma, Ning Zu. 1. Graduate School, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100032, China.
Abstract
BACKGROUND: To investigate the clinical features of cardiac involvement in polymyositis (PM) or dermatomyositis (DM). HYPOTHESIS: More attention will be focused on the heart in PM/DM as we would have wished, which contribute to improve the prognosis. METHODS: All articles published in English were retrieved by searching MEDLINE via PubMed (1975-2011). After selecting eligible articles according to the predefined inclusion and exclusion criteria, a systemic review was carried out. RESULTS: A total of 26 articles were included in this study, which included 1530 patients. The incidence of cardiac involvement was 9% to 72%. Heart failure was the most frequent (32% to 77%) clinical symptom. Among the abnormal electrocardiogram and ultrasonic cardiogram, the incidence of conduction abnormalities, left ventricular diastolic dysfunction, and hyperkinetic left ventricular contraction were 25% to 38.5%, 42%, and 6% to 12%, respectively. The pathologic findings revealed myocardial inflammation, degenerative changes and necrosis similar to that in skeletal muscles. Cardiac manifestations of some patients improved after glucocorticoid and immunosuppressant treatment. Thirty-seven patients (46.3%) died as a direct result of heart disease. CONCLUSIONS: Heart abnormalities are frequent in patients with PM/DM, most of which were subclinical. The efficacy of glucocorticoids and immunosuppressants is uncertain. Cardiac involvement is a common cause of death.
BACKGROUND: To investigate the clinical features of cardiac involvement in polymyositis (PM) or dermatomyositis (DM). HYPOTHESIS: More attention will be focused on the heart in PM/DM as we would have wished, which contribute to improve the prognosis. METHODS: All articles published in English were retrieved by searching MEDLINE via PubMed (1975-2011). After selecting eligible articles according to the predefined inclusion and exclusion criteria, a systemic review was carried out. RESULTS: A total of 26 articles were included in this study, which included 1530 patients. The incidence of cardiac involvement was 9% to 72%. Heart failure was the most frequent (32% to 77%) clinical symptom. Among the abnormal electrocardiogram and ultrasonic cardiogram, the incidence of conduction abnormalities, left ventricular diastolic dysfunction, and hyperkinetic left ventricular contraction were 25% to 38.5%, 42%, and 6% to 12%, respectively. The pathologic findings revealed myocardial inflammation, degenerative changes and necrosis similar to that in skeletal muscles. Cardiac manifestations of some patients improved after glucocorticoid and immunosuppressant treatment. Thirty-seven patients (46.3%) died as a direct result of heart disease. CONCLUSIONS:Heart abnormalities are frequent in patients with PM/DM, most of which were subclinical. The efficacy of glucocorticoids and immunosuppressants is uncertain. Cardiac involvement is a common cause of death.
Authors: Angela Rosenbohm; Dominik Buckert; Nora Gerischer; Thomas Walcher; Jan Kassubek; Wolfgang Rottbauer; Albert C Ludolph; Peter Bernhardt Journal: J Neurol Date: 2015-02-12 Impact factor: 4.849
Authors: Kavita Sharma; Ana-Maria Orbai; Dipan Desai; Oscar H Cingolani; Marc K Halushka; Lisa Christopher-Stine; Andrew L Mammen; Katherine C Wu; Sammy Zakaria Journal: J Card Fail Date: 2014-07-29 Impact factor: 5.712