Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Salford.
Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester, UK.
Curr Opin Rheumatol. 2020 Nov;32(6):528-533. doi: 10.1097/BOR.0000000000000753.
To examine recent developments relating to cardiac involvement in the adult idiopathic inflammatory myopathies (IIM) and those inherited muscle diseases which may present in adulthood and mimic IIM.
Cardiac involvement is a common feature of IIM and inherited muscle diseases. Frequency according to disease subtype varies, with serotype having particular influence in IIM, and genotype in the inherited muscle diseases. Innovative techniques for examining cardiac function have been investigated further, including speckle-tracking echocardiography and cardiac magnetic resonance tomography. The present work has highlighted a likely underestimate of the burden of cardiac disease to date. The complex relationship between IIM, atherosclerosis, and traditional cardiovascular risk factors has been further elucidated. Consensus recommendations for managing patients with inherited muscle diseases and prominent cardiac involvement have been recently published. In addition to supportive care, disease modifying treatments are increasingly becoming available for inherited muscle diseases which may also improve cardiac outcomes.
Cardiac involvement is associated with significant morbidity and mortality. We suggest having a low threshold for considering the possibility of cardiac involvement in all patients with muscle disease.
探讨与成人特发性炎性肌病（IIM）和可能在成年期出现并模仿 IIM 的遗传性肌肉疾病相关的心脏受累的最新进展。
心脏受累是 IIM 和遗传性肌肉疾病的常见特征。根据疾病亚型的不同，其发生率也有所不同，血清型在 IIM 中具有特殊影响，而基因型在遗传性肌肉疾病中具有特殊影响。进一步研究了心脏功能检查的创新技术，包括斑点追踪超声心动图和心脏磁共振断层扫描。目前的研究工作突出了迄今为止对心脏疾病负担的低估。进一步阐明了 IIM、动脉粥样硬化和传统心血管危险因素之间的复杂关系。最近发表了关于管理有明显心脏受累的遗传性肌肉疾病患者的共识建议。除了支持性护理外，越来越多的遗传性肌肉疾病可使用疾病修饰治疗，这也可能改善心脏预后。
心脏受累与显著的发病率和死亡率相关。我们建议对所有患有肌肉疾病的患者，都应降低考虑心脏受累可能性的门槛。
