Department of Medicine, Blacktown Hospital, 18 Blacktown Road, Blacktown, NSW, 2148, Australia.
Department of Medicine, KMC, Manipal, Karnartaka, 576104, India.
BMC Cardiovasc Disord. 2021 Jan 6;21(1):7. doi: 10.1186/s12872-020-01813-6.
Cardiac vasculitis is recognized as a heterogeneous disease process with a wide spectrum of manifestations including pericarditis, myocarditis, valvular heart disease and less frequently, coronary artery vasculitis (CAV). CAV encompasses an emerging field of diseases which differ from conventional atherosclerotic disease and have a proclivity for the younger population groups. CAV portends multiple complications including the development of coronary artery aneurysms, coronary stenotic lesions, and thrombosis, all which may result in acute coronary syndromes. There are several aetiologies for CAV; with Kawasaki's disease, Takayasu's arteritis, Polyarteritis Nodosa, and Giant-Cell Arteritis more frequently described clinically, and in literature. There is a growing role for multi-modality imaging in assisting the diagnostic process; including transthoracic echocardiography, cardiac magnetic resonance imaging, computed tomography coronary angiography, fluorodeoxyglucose-positron emission tomography and conventional coronary angiogram with intravascular ultrasound. Whilst the treatment paradigms fundamentally vary between different aetiologies, there are overlaps with pharmacological regimes in immunosuppressive agents and anti-platelet therapies. Interventional and surgical management are is a consideration in select populations groups, within a multi-disciplinary context. Further large-scale studies are required to better appropriately outline management protocols in this niche population.
心脏血管炎被认为是一种具有广泛表现的异质性疾病过程，包括心包炎、心肌炎、心瓣膜病，以及较少见的冠状动脉血管炎 (CAV)。CAV 涵盖了一个新兴的疾病领域，与传统的动脉粥样硬化疾病不同，并且更容易发生在年轻人群中。CAV 预示着多种并发症，包括冠状动脉瘤、冠状动脉狭窄病变和血栓形成，所有这些都可能导致急性冠状动脉综合征。CAV 有几种病因；川崎病、大动脉炎、结节性多动脉炎和巨细胞动脉炎在临床上和文献中更为常见。多模态成像在协助诊断过程中发挥着越来越重要的作用；包括经胸超声心动图、心脏磁共振成像、计算机断层扫描冠状动脉造影、氟脱氧葡萄糖正电子发射断层扫描和传统冠状动脉血管造影伴血管内超声。虽然不同病因的治疗模式有根本的不同，但在免疫抑制剂和抗血小板治疗的药物方案上存在重叠。在多学科背景下，介入和手术治疗是特定人群的一种考虑因素。需要进一步的大规模研究来更好地为这一特定人群制定管理方案。
