Trybuch Agnieszka, Tarnacka Beata
Department of Rehabilitation, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Department of Rehabilitation, Medical University of Warsaw, Poland.
Reumatologia. 2023;61(3):202-212. doi: 10.5114/reum/168362. Epub 2023 Jul 2.
Polymyositis (PM) and dermatomyositis (DM) are rare idiopathic inflammatory myopathies (IIM). Myocardial involvement in patients with IIM is an unfavorable prognostic factor and one of the most common cause of mortality in this group of patients. The purpose of this review is to present current knowledge on cardiovascular manifestations observed in IIM. Data published in English until December 2021 were selected. Clinical symptoms suggesting cardiac involvement are non-specific and require a differential diagnosis in accordance with cardiological guidelines. Troponin I is specific to cardiac injury and should be preferred to other markers to evaluate the myocardium in IIM. Abnormalities in electrocardiography are common in IIM, especially non-specific changes of the ST-T segment. In standard echocardiography left ventricular diastolic dysfunction is reported frequently. New diagnostic technologies can reveal clinically silent myocardial abnormalities. However, the prognostic value of subclinical impairment of myocardial function require further studies.
多发性肌炎（PM）和皮肌炎（DM）是罕见的特发性炎性肌病（IIM）。IIM患者的心肌受累是一个不良预后因素，也是该组患者最常见的死亡原因之一。本综述的目的是介绍目前关于IIM中心血管表现的知识。选取了截至2021年12月以英文发表的数据。提示心脏受累的临床症状不具有特异性，需要根据心脏病学指南进行鉴别诊断。肌钙蛋白I对心脏损伤具有特异性，在评估IIM患者的心肌时应优先于其他标志物。心电图异常在IIM中很常见，尤其是ST-T段的非特异性改变。在标准超声心动图检查中，左心室舒张功能障碍的报告较为频繁。新的诊断技术可以发现临床上无症状的心肌异常。然而，心肌功能亚临床损害的预后价值需要进一步研究。
