Mavrogeni Sophie I, Markousis-Mavrogenis George, Heutemann David, van Wijk Kees, Reiber Hans J, Kolovou Genovefa
Sophie I Mavrogeni, George Markousis-Mavrogenis, Genovefa Kolovou, Onassis Cardiac Surgery Center, 17674 Athens, Greece.
World J Methodol. 2015 Sep 26;5(3):136-43. doi: 10.5662/wjm.v5.i3.136.
Cardiovascular involvement in rheumatic diseases (RD) is the result of various pathophysiologic mechanisms including inflammation, accelerated atherosclerosis, myocardial ischemia, due to micro- or macro-vascular lesions and fibrosis. Noninvasive cardiovascular imaging, including echocardiography, nuclear techniques, cardiovascular computed tomography and cardiovascular magnetic resonance, represents the main diagnostic tool for early, non-invasive diagnosis of heart disease in RD. However, in the era of multimodality imaging and financial crisis there is an imperative need for rational use of imaging techniques in order to obtain the maximum benefit at the lowest possible cost for the health insurance system. The oligo-asymptomatic cardiovascular presentation and the high cardiovascular mortality of RD necessitate a reliable and reproducible diagnostic approach to catch early cardiovascular involvement. Echocardiography remains the routine cornerstone of cardiovascular evaluation. However, a normal echocardiogram can not always exclude cardiac involvement and/or identify heart disease acuity and pathophysiology. Therefore, cardiovascular magnetic resonance is a necessary adjunct complementary to echocardiography, especially in new onset heart failure and when there are conflicting data from clinical, electrocardiographic and echocardiographic evaluation of RD patients.
风湿性疾病（RD）中的心血管受累是多种病理生理机制的结果，包括炎症、动脉粥样硬化加速、心肌缺血，这是由微血管或大血管病变以及纤维化引起的。非侵入性心血管成像，包括超声心动图、核技术、心血管计算机断层扫描和心血管磁共振成像，是RD中心脏疾病早期非侵入性诊断的主要诊断工具。然而，在多模态成像和金融危机的时代，迫切需要合理使用成像技术，以便以尽可能低的成本为医疗保险系统获得最大效益。RD的心血管症状少且心血管死亡率高，因此需要一种可靠且可重复的诊断方法来早期发现心血管受累情况。超声心动图仍然是心血管评估的常规基石。然而，正常的超声心动图并不总能排除心脏受累和/或确定心脏病的严重程度及病理生理情况。因此，心血管磁共振成像是超声心动图的必要辅助补充手段，特别是在新发心力衰竭以及对RD患者进行临床、心电图和超声心动图评估出现相互矛盾的数据时。
