Cardiac Abnormalities in Adult Patients With Polymyositis or Dermatomyositis as Assessed by Noninvasive Modalities
Cardiac Abnormalities in Adult Patients With Polymyositis or Dermatomyositis as Assessed by Noninvasive Modalities
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DOI：
10.1002/acr.22772
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发表时间：
2016-07-01
影响因子：
4.7
通讯作者：
Jacobsen, S.
中科院分区：
文献类型：
--
作者：
Diederichsen, L. P.;Simonsen, J. A.;Jacobsen, S.
心脏事件是特发性炎性肌病患者死亡的主要原因。本研究的目的是在一个对照组中通过非侵入性方法描述多发性肌炎（PM）或皮肌炎（DM）患者队列中的心脏异常，并确定心功能不全的预测因子。组织多普勒超声心动图成像和定量心脏Tc-99 m-焦磷酸结果与HC相比，PM/DM患者更易出现左室舒张功能障碍（LVDD）。（12%对0%; P=0.02）和QRS和QT间期延长（分别为P=0.007和P < 0.0001）。在多变量分析中，与LVDD相关的因素是年龄（P=0.001）、病程（P=0.004）、肌炎特异性或相关自身抗体（P=0.05）和心脏高Tc-99 m-PYP摄取（P=0.006）。在对患者和HC的汇总数据进行多变量分析时，PM/DM的诊断（P < 0.0001）与LVDD.ConclusionPatients与PM或DM相比HC心脏异常的患病率增加。LVDD在PM/DM患者中常见，并与疾病持续时间相关。此外，LVDD与肌炎特异性或相关自身抗体和高心脏Tc-99 m-PYP摄取的相关性支持PM/DM患者潜在自身免疫和心肌炎症的概念。
ObjectiveCardiac 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.MethodsIn 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 Tc-99m-pyrophosphate (Tc-99m-PYP) scintigraphy.ResultsCompared to HCs, patients with PM/DM more frequently had left ventricular diastolic dysfunction (LVDD) (12% versus 0%; P=0.02) and longer QRS and QT intervals (P=0.007 and P < 0.0001, respectively). In multivariate analysis, factors associated with LVDD were age (P=0.001), disease duration (P=0.004), presence of myositis-specific or -associated autoantibodies (P=0.05), and high cardiac Tc-99m-PYP uptake (P=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.ConclusionPatients 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 Tc-99m-PYP uptake supports the notion of underlying autoimmunity and myocardial inflammation in patients with PM/DM.