Goldar Ghazaleh, Garraud Cassandra, Sifuentes Aaron A, Wassif Heba, Jain Vardhmaan, Klein Allan L
Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Ave., Desk J1-5, Cleveland, OH, 44195, USA.
University of Michigan Department of Internal Medicine, Ann Arbor, MI, USA.
Curr Cardiol Rep. 2022 Nov;24(11):1633-1645. doi: 10.1007/s11886-022-01785-3. Epub 2022 Oct 11.
The purpose of this review is to understand the underlying mechanism that leads to pericarditis in systemic autoimmune and autoinflammatory diseases. The underlying mechanism plays a vital role in the appropriate management of patients. In addition, we will review the current landscape of available cardiac imaging modalities with emphasis on pericardial conditions as well as proposed treatment and management tailored toward pericardial autoimmune and autoinflammatory processes.
Approximately 22% of all cases of pericarditis with a known etiology are caused by systemic autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, and vasculitis. In recent years, there have been advancements of imaging modalities including cardiac MRI, cardiac CT scan, and PET scan and their respective nuances in regard to contrast use, technique, and views which clinicians may utilize to better understand the extent of a patient's pericardial pathology and the trajectory of his or her disease process. In this review, we will discuss systemic autoimmune and autoinflammatory diseases that involve the pericardium. We will also review different imaging modalities that are currently used to further characterize such conditions. Having a deeper understanding of such techniques will improve patient outcomes by helping clinicians tailor treatment plans according to the unique underlying condition.
本综述旨在了解导致系统性自身免疫性疾病和自身炎症性疾病中心包炎的潜在机制。该潜在机制在患者的恰当管理中起着至关重要的作用。此外，我们将综述当前可用的心脏成像模式，重点关注心包状况以及针对心包自身免疫和自身炎症过程的拟议治疗与管理。
在所有已知病因的心包炎病例中，约22%由系统性自身免疫性疾病引起，如系统性红斑狼疮、类风湿关节炎、系统性硬化症和血管炎。近年来，成像模式不断发展，包括心脏磁共振成像、心脏计算机断层扫描和正电子发射断层扫描，以及它们在造影剂使用、技术和视图方面各自的细微差别，临床医生可利用这些来更好地了解患者心包病变的程度及其疾病进程的轨迹。在本综述中，我们将讨论累及心包的系统性自身免疫性疾病和自身炎症性疾病。我们还将综述目前用于进一步明确此类病症的不同成像模式。更深入地了解这些技术将有助于临床医生根据独特的潜在病情制定治疗方案，从而改善患者的治疗效果。
