Zhu Hongji, Li Runzhao, Tan Hongxia, Ding Tangdan, Yuan Ying, Wen Zhihua, Zhao Jijun, Liu Min, Shi Qiong, Li Liubing
Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
Department of Laboratory Medicine, Nansha Division of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
J Inflamm Res. 2025 Mar 14;18:3879-3888. doi: 10.2147/JIR.S503928. eCollection 2025.
Idiopathic inflammatory myopathies (IIMs) are a group of autoimmune diseases that includes the main subtypes dermatomyositis, polymyositis, immune-mediated necrotizing myopathy, and inclusion body myositis. IIMs are characterized by the involvement of skeletal muscle and multiple organs, including the heart. This review summarizes the pathology, prevalence, biomarkers, imaging and treatment of cardiac involvement in patients with IIMs. The cardiac involvement in these patients is usually subclinical and rarely considered as the main clinical feature at the time of initial consultation, with a prevalence ranging from 4% to 26%. However, it results in a worse prognosis and represents the main cause of mortality in patients with IIMs. The selection of specific serum cardiac biomarkers is essential for the early detection of cardiac involvement in patients with IIMs, such as cardiac troponin I (cTnI), which is preferred over cardiac troponin T (cTnT), followed by diagnostic evaluations including electrocardiography (ECG), echocardiography (ECHO), and cardiac magnetic resonance imaging (CMR). The combination of glucocorticoids, immunosuppressants, and conventional cardiac medications is effective for the management of IIM patients with confirmed cardiac involvement.
特发性炎症性肌病（IIMs）是一组自身免疫性疾病，包括主要亚型皮肌炎、多发性肌炎、免疫介导的坏死性肌病和包涵体肌炎。IIMs的特征是骨骼肌和包括心脏在内的多个器官受累。本综述总结了IIMs患者心脏受累的病理学、患病率、生物标志物、影像学及治疗。这些患者的心脏受累通常为亚临床状态，在初次就诊时很少被视为主要临床特征，患病率为4%至26%。然而，它会导致预后更差，是IIMs患者死亡的主要原因。选择特定的血清心脏生物标志物对于早期检测IIMs患者的心脏受累至关重要，如心肌肌钙蛋白I（cTnI），其优于心肌肌钙蛋白T（cTnT），随后进行包括心电图（ECG）、超声心动图（ECHO）和心脏磁共振成像（CMR）在内的诊断评估。糖皮质激素、免疫抑制剂和传统心脏药物联合使用对确诊有心脏受累的IIMs患者的治疗有效。
