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炎症性肠病的心血管表现:发病机制、诊断及预防策略

Cardiovascular Manifestations of Inflammatory Bowel Disease: Pathogenesis, Diagnosis, and Preventive Strategies.

作者信息

Bunu Diana-Maria, Timofte Cristian-Eugen, Ciocoiu Manuela, Floria Mariana, Tarniceriu Claudia-Cristina, Barboi Oana-Bogdana, Tanase Daniela-Maria

机构信息

Department of Cardiology, Institute of Cardiovascular Diseases, Timisoara 300310, Romania.

Department of Radiology, County Emergency Hospital Timisoara, Timisoara 300723, Romania.

出版信息

Gastroenterol Res Pract. 2019 Jan 13;2019:3012509. doi: 10.1155/2019/3012509. eCollection 2019.

Abstract

Inflammatory bowel disease (IBD) refers to a group of chronic inflammatory diseases that targets mainly the gastrointestinal tract. The clinical presentation of IBD includes both gastrointestinal manifestations and extraintestinal manifestations (EIM). The reported cardiovascular manifestations in IBD patients include pericarditis, myocarditis, venous and arterial thromboembolism, arrhythmias, atrioventricular block, heart failure, endocarditis, valvulopathies, and Takayasu arteritis. The aim of this article is to review the available literature about the possible pathogenic mechanisms and determine preventive measures capable of reducing the incidence and severity of the cardiovascular manifestations. In IBD patients, the incidence of cardiovascular manifestations is low, but higher than that in the general population. Therefore, clinicians should pay attention to any new modification that might indicate cardiovascular involvement in IBD patients, and they should consider chronic inflammatory diseases in patients with cardiac conditions without an evident cause. Considering the role of inflammation in the development of cardiovascular manifestations, the management should include prevention of flares and maintenance of remission for as long as possible. Preventive measures should also include active screening and strict control of the cardiovascular risk factors in all IBD patients.

摘要

炎症性肠病(IBD)是指一组主要累及胃肠道的慢性炎症性疾病。IBD的临床表现包括胃肠道表现和肠外表现(EIM)。IBD患者中报道的心血管表现包括心包炎、心肌炎、静脉和动脉血栓栓塞、心律失常、房室传导阻滞、心力衰竭、心内膜炎、瓣膜病和高安动脉炎。本文的目的是回顾关于可能的致病机制的现有文献,并确定能够降低心血管表现的发生率和严重程度的预防措施。在IBD患者中,心血管表现的发生率较低,但高于普通人群。因此,临床医生应注意任何可能提示IBD患者心血管受累的新变化,对于无明显病因的心脏疾病患者应考虑慢性炎症性疾病。考虑到炎症在心血管表现发展中的作用,管理应包括预防病情发作并尽可能维持缓解状态。预防措施还应包括对所有IBD患者进行积极筛查和严格控制心血管危险因素。

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