特发性炎症性肌病的心血管表现

Cardiac Involvement in Idiopathic Inflammatory Myopathies

心脏损害是特发性炎症性肌病死亡和致残的重要原因。然而,心力衰竭、传导异常及冠心病等临床心血管表现相对少见,非特异性的心电图显示的传导异常及心律失常却很常见。事实上,这些心血管表现或多或少与心肌纤维化及小血管平滑肌增生相关,可致特发性炎症性肌病患者的死亡。因此,有必要推荐特发性炎症性肌病患者进行常规而全面的心脏评估。

Cardiac involvement is an important cause of morbidity and mortality in patients with idiopathic inflammatory myopathies. Despite this, clinically manifest cardiac involvement in polymyositis and dermatomyositis, such as congestive heart failure, conduction abnormalities and coronary artery disease, is relatively rare, and subclinical manifestations are frequently reported and are predominated by conduction abnormalities and arrhythmias detected by ECG. Here, myocardial fibrosis puts the patient at risk for systolic or diastolic heart failure and dysrhythmias, which may constitute a major cause of death in myositis. Therefore, it is reasonable to suggest that these patients should be routinely and comprehensively evaluated for cardiac involvement.