Mavrogeni Sophie, Sfikakis Petros P, Dimitroulas Theodoros, Kolovou Genovefa, Kitas George D
Onassis Cardiac Surgery Center, 50 Esperou Street, 175-61 P.Faliro, Athens, Greece.
Inflamm Allergy Drug Targets. 2014;13(3):206-16. doi: 10.2174/1871528113666140526162640.
Idiopathic inflammatory myopathies (IIMs) are rare autoimmune diseases and include dermatomyositis, polymyositis, necrotizing myopathy and inclusion body myositis; they are characterized by inflammation of skeletal muscle and other internal organs and may potentially lead to irreversible damage and death. Only a small percentage of IIM has clinically overt cardiac disease; however, heart involvement is one of the leading causes of death and therefore, early detection remains a challenge. Biochemical markers and non-invasive methods such as the electrocardiogram and echocardiography have a role in diagnosis, but lack sensitivity in identifying patients with early, sublinical cardiac abnormalities. Endomyocardial and skeletal muscle biopsies are very useful, but invasive techniques and cannot be used for routine follow-up. Cardiac and skeletal magnetic resonance imaging, due to their capability to perform tissue characterization, has emerged as novel techniques for the early detection and follow-up of myocardial and skeletal muscle tissue changes (oedema, inflammation, fibrosis) in IIM. However, the clinical implications of using these approaches and their cost /benefit ratio require further evaluation.
特发性炎性肌病（IIM）是罕见的自身免疫性疾病，包括皮肌炎、多发性肌炎、坏死性肌病和包涵体肌炎；其特征为骨骼肌和其他内脏器官的炎症，可能导致不可逆的损害甚至死亡。仅有一小部分IIM患者有明显的临床心脏病表现；然而，心脏受累是主要死因之一，因此早期检测仍是一项挑战。生化标志物以及心电图和超声心动图等非侵入性方法在诊断中发挥一定作用，但在识别早期亚临床心脏异常患者方面缺乏敏感性。心内膜和骨骼肌活检非常有用，但属于侵入性技术，不能用于常规随访。心脏和骨骼肌磁共振成像因其能够进行组织特征分析，已成为早期检测和随访IIM患者心肌和骨骼肌组织变化（水肿、炎症、纤维化）的新技术。然而，使用这些方法的临床意义及其成本效益比仍需进一步评估。
