Royal National Hospital for Rheumatic Diseases, Bath, BA1 1RL, UK.
Clin Rheumatol. 2014 Mar;33(3):435-8. doi: 10.1007/s10067-013-2405-1. Epub 2013 Oct 3.
Cardiac involvement in systemic sclerosis (SSc) is heterogeneous and can include primary involvement of the myocardium, pericardium and coronary arteries or be secondary to cardiac complications of pulmonary and renal disease. Primary cardiac involvement in SSc is uncommon but can result in ventricular dysfunction, organ failure, arrhythmias and death. It can remain clinically silent and the prevalence is likely to be under-reported. We report four cases of SSc associated with a raised serum troponin T (TnT), in a proportion of whom cardiac MRI myocardial abnormalities were detected. These cases highlight the heterogeneity of cardiac involvement in SSc, the role of cardiac MRI and promising biochemical responses to immunosuppression. Cardiac biomarkers such as TnT may be useful screening tools to identify subclinical cardiac disease and assess response to therapeutic intervention.
系统性硬化症（SSc）的心脏受累具有异质性，可包括心肌、心包和冠状动脉的原发性受累，也可继发于肺部和肾脏疾病的心脏并发症。SSc 的原发性心脏受累并不常见，但可导致心室功能障碍、器官衰竭、心律失常和死亡。它可能在临床上仍然没有症状，而且其患病率可能被低估了。我们报告了 4 例与血清肌钙蛋白 T（TnT）升高相关的 SSc 病例，其中一部分患者检测到心脏 MRI 心肌异常。这些病例突出了 SSc 中心脏受累的异质性、心脏 MRI 的作用以及免疫抑制治疗的有希望的生化反应。肌钙蛋白 T 等心脏生物标志物可能是识别亚临床心脏疾病和评估治疗干预反应的有用筛查工具。
