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自身免疫性疾病女性的心脏风险评估。

Assessment of Cardiac Risk in Women with Autoimmune Disease.

机构信息

Department of Cardiovascular Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.

出版信息

Curr Cardiol Rep. 2022 Jul;24(7):775-784. doi: 10.1007/s11886-022-01698-1. Epub 2022 May 7.

Abstract

PURPOSE OF REVIEW

The purpose of our review was to evaluate current standards in clinical practice in determining overall cardiac risk in female patients with chronic rheumatologic diseases. We hoped to not only summarize known cardiac manifestations of various chronic rheumatologic diseases but also determine the effectiveness of new risk scores in determining cardiac risk in this patient population.

RECENT FINDINGS

Chronic rheumatologic diseases have been associated with various cardiac manifestations for some time, with initial studies involving risk of coronary artery disease (CAD) in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). However, recent studies have shown numerous other cardiac manifestations associated with these and other chronic rheumatologic diseases. Risk scores have been used for several decades to help determine overall cardiac risk in the general population, but these risk scores have notoriously underestimated the risk of cardiac disease in woman and in patients with chronic rheumatologic diseases. These diseases, often with a female predominance, can impact long-term mortality and have devastating consequences if not monitored and treated appropriately. Thus, new risk scores have been developed over the last several years to help improve detection and awareness of cardiac disease in these patients. Novel modified risk scores have found some success at improving the detection of cardiac disease in patients with chronic rheumatologic diseases. Further studies looking at these risk scores need to determine the accuracy of these scores and where they fall short. With the advent of advanced imaging technologies, future risk scores may involve certain imaging-based markers to help guide accurate risk determination.

摘要

目的综述

本综述旨在评估目前在慢性风湿性疾病女性患者中确定整体心脏风险的临床实践标准。我们不仅希望总结各种慢性风湿性疾病的已知心脏表现,还希望确定新风险评分在确定该患者人群中心脏风险方面的有效性。

最近的发现

长期以来,慢性风湿性疾病与各种心脏表现相关,最初的研究涉及类风湿关节炎(RA)和系统性红斑狼疮(SLE)中的冠状动脉疾病(CAD)风险。然而,最近的研究表明,这些疾病和其他慢性风湿性疾病还有许多其他心脏表现。几十年来,风险评分一直被用于帮助确定普通人群的整体心脏风险,但这些风险评分在女性和慢性风湿性疾病患者中心脏疾病风险的评估上存在明显低估。这些疾病通常以女性为主,会对长期死亡率产生影响,如果不进行适当的监测和治疗,会产生灾难性的后果。因此,近年来开发了新的风险评分,以帮助提高对这些患者中心脏疾病的检测和认识。新型改良风险评分在提高慢性风湿性疾病患者中心脏疾病的检测方面取得了一定的成功。需要进一步的研究来确定这些评分的准确性以及它们的不足之处。随着先进成像技术的出现,未来的风险评分可能涉及某些基于成像的标志物,以帮助指导准确的风险确定。

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