Ito Takahide, Akamatsu Kanako, Morita Hideaki
Department of Cardiology, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Osaka, 569-8686, Takatsuki, Japan.
Int J Cardiovasc Imaging. 2025 Sep 15. doi: 10.1007/s10554-025-03513-8.
Collagen diseases are chronic inflammatory disorders that systematically affect connective tissues of the entire body, including the skin, joints, and kidneys. Cardiac involvement is not uncommon in collagen diseases. Pulmonary hypertension is the most prevalent complication, followed by systolic and diastolic dysfunction, conduction abnormalities, perimyocarditis, and valvular disease. The recent advent of echocardiographic techniques has enabled the detection of subclinical cardiac changes in collagen diseases. In systemic sclerosis, exercise echocardiography can unmask pulmonary artery hypertension. Speckle tracking echocardiography applied to the right ventricle in systemic sclerosis is useful for assessing the degree of chronic right ventricular pressure overload in addition to the irreversible pathological processes affecting the pulmonary vasculature. In systemic lupus erythematosus, three-dimensional echocardiography provides a clearer visualization of Libman-Sacks endocarditis lesions compared to two-dimensional echocardiography. Dermatomyositis, as well as rheumatoid arthritis, has traditionally been associated with pericardial effusion due to perimyocarditis and, more recently, with diastolic dysfunction and myocardial hypertrophy. Here, we present echocardiographic findings for representative types of collagen diseases, highlighting their characteristic features and providing accompanying images for each.
胶原病是一类慢性炎症性疾病，可系统性地累及全身的结缔组织，包括皮肤、关节和肾脏。心脏受累在胶原病中并不少见。肺动脉高压是最常见的并发症，其次是收缩和舒张功能障碍、传导异常、心肌心包炎和瓣膜病。近年来超声心动图技术的出现，使得在胶原病中能够检测到亚临床心脏改变。在系统性硬化症中，运动超声心动图可发现肺动脉高压。应用于系统性硬化症右心室的斑点追踪超声心动图，除了可评估影响肺血管系统的不可逆病理过程外，还可用于评估慢性右心室压力超负荷的程度。在系统性红斑狼疮中，与二维超声心动图相比，三维超声心动图能更清晰地显示Libman-Sacks心内膜炎病变。传统上，皮肌炎以及类风湿关节炎与心肌心包炎导致的心包积液有关，最近还与舒张功能障碍和心肌肥厚有关。在此，我们展示了代表性类型胶原病的超声心动图表现，突出其特征，并为每种疾病提供了相应图像。
