Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
JACC Cardiovasc Imaging. 2024 Aug;17(8):937-988. doi: 10.1016/j.jcmg.2024.04.010.
Pericardial diseases have gained renewed clinical interest, leading to a renaissance in the field. There have been many recent advances in pericardial diseases in both multimodality cardiac imaging of diagnoses, such as recurrent, transient constrictive and effusive-constrictive pericarditis, and targeted therapeutics, especially anti-interleukin (IL)-1 agents that affect the inflammasome as part of autoinflammatory pathophysiology. There remains a large educational gap for clinicians, leading to variability in evaluation and management of these patients. The latest pericardial imaging (American Society of Echocardiography, European Association of Cardiovascular Imaging) and clinical guidelines (European Society of Cardiology) are >8-10 years of age and may not reflect current practice. Recent clinical trials involving anti-IL-1 agents in recurrent pericarditis, including anakinra (AIRTRIP), rilonacept (RHAPSODY), and goflikicept have demonstrated their efficacy. The present document represents an international position statement from world leaders in the pericardial field, focusing on novel concepts and emphasizing the role of multimodality cardiac imaging as well as new therapeutics in pericardial diseases.
心包疾病重新引起临床关注,该领域迎来复兴。在心包疾病的多模态心脏成像诊断方面取得了许多新进展,例如复发性、短暂性缩窄性和渗出性缩窄性心包炎,以及靶向治疗,特别是影响炎症小体的抗白细胞介素(IL)-1 药物,作为自身炎症病理生理学的一部分。临床医生仍然存在很大的教育差距,导致这些患者的评估和管理存在差异。最新的心包影像学(美国超声心动图学会、欧洲心血管成像协会)和临床指南(欧洲心脏病学会)已有>8-10 年的历史,可能无法反映当前的实践。最近涉及复发性心包炎的抗 IL-1 药物的临床试验,包括阿那白滞素(AIRTRIP)、利那鲁肽(RHAPSODY)和 goflikicept,已经证明了它们的疗效。本文件代表心包领域世界领先者的国际立场声明,重点关注新概念,并强调多模态心脏成像以及心包疾病新疗法的作用。