Fujii Masayoshi, Onishi Tetsuari, Yamamoto Hiroyuki, Takahashi Nobuyuki, Takaya Tomofumi, Kawai Hiroya
Division of Cardiovascular Medicine, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, Hyogo, Japan.
J Cardiol Cases. 2024 Jul 14;30(3):90-93. doi: 10.1016/j.jccase.2024.06.001. eCollection 2024 Sep.
Polymyositis (PM) and dermatomyositis (DM) are chronic inflammatory muscle disorders characterized by muscle weakness and fatigue. They are histopathologically defined by inflammatory cell infiltrates in the skeletal muscle. In a recent meta-analysis, the incidence of cardiovascular complications in patients with PM/DM ranged from 9 to 72 %, with heart failure being the most commonly reported heart disease. In cases of heart failure accompanied by severe mitral regurgitation that is refractory due to guideline-directed medical therapy, the transcatheter edge-to-edge mitral valve repair (TEER) procedure using the MitraClip (Abbott Vascular, Santa Clara, CA, USA) offers an alternative therapeutic approach. We present a pioneering case report describing the successful application of TEER in a young woman with drug-refractory heart failure due to cardiovascular involvement in PM.
•In polymyositis (PM)/ dermatomyositis (DM), the most commonly reported clinical heart disorder is heart failure, with some cases attributed to mitral regurgitation.•Patients suffering from systemic inflammatory diseases such as PM/DM often face high surgical risk, and the MitraClip is an effective treatment modality.
多发性肌炎（PM）和皮肌炎（DM）是慢性炎症性肌肉疾病，其特征为肌肉无力和疲劳。它们在组织病理学上的定义是骨骼肌中有炎症细胞浸润。在最近的一项荟萃分析中，PM/DM患者心血管并发症的发生率在9%至72%之间，心力衰竭是最常报告的心脏病。在因指南指导的药物治疗而难治的伴有严重二尖瓣反流的心力衰竭病例中，使用MitraClip（美国加利福尼亚州圣克拉拉市雅培血管公司）进行经导管缘对缘二尖瓣修复（TEER）手术提供了一种替代治疗方法。我们报告了一例开创性病例，描述了TEER在一名因PM心血管受累导致药物难治性心力衰竭的年轻女性中的成功应用。
•在多发性肌炎（PM）/皮肌炎（DM）中，最常报告的临床心脏疾病是心力衰竭，有些病例归因于二尖瓣反流。•患有PM/DM等全身性炎症性疾病的患者通常面临高手术风险，而MitraClip是一种有效的治疗方式。
