Onassis Cardiac Surgery Center, Athens, Greece.
, Athens, Greece.
Rheumatol Int. 2018 Aug;38(8):1355-1362. doi: 10.1007/s00296-018-4078-1. Epub 2018 Jun 6.
Juvenile idiopathic arthritis (JIA) is the commonest rheumatic disease in childhood and presents several subtypes according to the ILAR classification. JIA, specifically in its systemic form, may seriously damage various structures of the cardiovascular system. Other JIA phenotypes are also of interest, as cardiovascular disease (CVD) is underestimated and understudied, but chronic systemic inflammation and risk factors remained important contributors for CVD development. The currently applied non-invasive modalities, although they are important for the initial evaluation of JIA patients, frequently fail to detect the silent, subclinical forms of CVD. Cardiovascular magnetic resonance (CMR), due to its multifaceted capability in the detection of cardiovascular disease, can offer early, reproducible, non-invasive information about cardiovascular disease in JIA, allowing risk stratification and timely initiation /modification of cardiologic and anti-rheumatic treatment. However, lack of availability/expertise and high cost still hamper its application in the clinical cardio-rheumatic practice. The aim of the current article is to present an overview of CVD in JIA emphasizing the emerging role of CMR in early diagnosis and treatment follow-up of CVD in JIA patients.
幼年特发性关节炎（JIA）是儿童中最常见的风湿性疾病，根据 ILAR 分类，有几种亚型。JIA，特别是其全身型，可能严重损害心血管系统的各种结构。其他 JIA 表型也很重要，因为心血管疾病（CVD）被低估和研究不足，但慢性全身炎症和危险因素仍然是 CVD 发展的重要因素。目前应用的非侵入性方式虽然对 JIA 患者的初始评估很重要，但经常无法检测到 CVD 的无声、亚临床形式。心血管磁共振（CMR）由于其在心血管疾病检测方面的多方面能力，可以提供 JIA 心血管疾病的早期、可重复、非侵入性信息，从而进行风险分层，并及时开始/修改心脏和抗风湿治疗。然而，缺乏可用性/专业知识和高成本仍然阻碍了它在临床心脏风湿学实践中的应用。本文的目的是介绍 JIA 中的 CVD 概述，强调 CMR 在 JIA 患者 CVD 的早期诊断和治疗随访中的新兴作用。
