Opinc Aleksandra, Brzezińska Olga, Makowska Joanna
Department of Rheumatology, Medical University of Lodz, Poland.
Reumatologia. 2021;59(5):276-284. doi: 10.5114/reum.2021.110609. Epub 2021 Nov 7.
In the course of idiopathic inflammatory myopathies internal organs, including heart and lungs, can be involved. Cardiopulmonary complications significantly alter the course of the disease, leading to poorer prognosis. A lack of clear guidelines on the assessment of internal organ involvement in the course of myositis increases the risk of underdiagnosis. The aim of the study was to evaluate the incidence of clinical symptoms indicative of cardiovascular and pulmonary involvement in patients with myositis, and the impact of these ailments on daily living.
A self-designed online survey was distributed via online support groups and community forums for patients with idiopathic inflammatory myopathies. The questionnaire contained inquiries about demographical data, clinical symptoms, including symptoms indicative of cardiopulmonary involvement, as well as the standardised Health Assessment Questionnaire. Respondents were divided according to concomitant diseases into a subgroup diagnosed with cardiopulmonary diseases and a subgroup without such comorbidities. The prevalence of cardiopulmonary symptoms was compared between the subgroups. The impact of cardiopulmonary symptoms on the degree of disability and daily functioning was assessed.
In total, 370 patients were included in the study group. The most commonly symptoms included dyspnoea during exercise, palpitations and ankle oedema during daily activities. Cardiopulmonary symptoms were frequent in respondents diagnosed with cardiopulmonary diseases and in patients declaring no comorbidities of the heart and lungs. Intensity of chest pain, tolerance of physical activity, and fatigue were comparable in both of the study subgroups. The degree of disability was higher in respondents with concomitant cardiovascular and/or pulmonary comorbidities, but only dry cough and ankle oedema impacted the results.
Clinical symptoms indicative of heart and lung involvement occur frequently in patients with idiopathic inflammatory myopathies; however, cardiopulmonary complications seem to be relatively rarely detected. Active screening for cardiopulmonary involvement is recommended.
在特发性炎性肌病病程中，包括心脏和肺在内的内脏器官可能会受累。心肺并发症会显著改变疾病进程，导致预后较差。在肌炎病程中，缺乏关于评估内脏器官受累情况的明确指南会增加漏诊风险。本研究的目的是评估肌炎患者中提示心血管和肺部受累的临床症状发生率，以及这些疾病对日常生活的影响。
通过针对特发性炎性肌病患者的在线支持小组和社区论坛分发自行设计的在线调查问卷。问卷包含有关人口统计学数据、临床症状（包括提示心肺受累的症状）以及标准化健康评估问卷的询问。根据伴发疾病将受访者分为诊断为心肺疾病的亚组和无此类合并症的亚组。比较亚组之间心肺症状的患病率。评估心肺症状对残疾程度和日常功能的影响。
研究组共纳入370例患者。最常见的症状包括运动时呼吸困难、日常活动时心悸和脚踝水肿。在诊断为心肺疾病的受访者以及声明无心肺合并症的患者中，心肺症状很常见。两个研究亚组的胸痛强度、体力活动耐量和疲劳程度相当。伴有心血管和/或肺部合并症的受访者残疾程度较高，但只有干咳和脚踝水肿影响结果。
特发性炎性肌病患者中提示心脏和肺部受累的临床症状频繁出现；然而，心肺并发症似乎相对较少被检测到。建议积极筛查心肺受累情况。
