Cardiac and muscular involvement in idiopathic inflammatory myopathies: noninvasive diagnostic assessment and the role of cardiovascular and skeletal magnetic resonance imaging.

Sophie Mavrogeni, Petros P Sfikakis, Theodoros Dimitroulas, Genovefa Kolovou, George D Kitas
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引用次数: 27

Abstract

Idiopathic inflammatory myopathies (IIMs) are rare autoimmune diseases and include dermatomyositis, polymyositis, necrotizing myopathy and inclusion body myositis; they are characterized by inflammation of skeletal muscle and other internal organs and may potentially lead to irreversible damage and death. Only a small percentage of IIM has clinically overt cardiac disease; however, heart involvement is one of the leading causes of death and therefore, early detection remains a challenge. Biochemical markers and non-invasive methods such as the electrocardiogram and echocardiography have a role in diagnosis, but lack sensitivity in identifying patients with early, sublinical cardiac abnormalities. Endomyocardial and skeletal muscle biopsies are very useful, but invasive techniques and cannot be used for routine follow-up. Cardiac and skeletal magnetic resonance imaging, due to their capability to perform tissue characterization, has emerged as novel techniques for the early detection and follow-up of myocardial and skeletal muscle tissue changes (oedema, inflammation, fibrosis) in IIM. However, the clinical implications of using these approaches and their cost /benefit ratio require further evaluation.

特发性炎性肌病的心脏和肌肉受累:无创诊断评估和心血管和骨骼磁共振成像的作用。
特发性炎症性肌病(IIMs)是一种罕见的自身免疫性疾病,包括皮肌炎、多发性肌炎、坏死性肌病和包涵体肌炎;它们的特点是骨骼肌和其他内脏器官的炎症,并可能导致不可逆转的损害和死亡。只有一小部分IIM患者有临床上明显的心脏病;然而,心脏受累是导致死亡的主要原因之一,因此,早期发现仍然是一项挑战。生化标志物和非侵入性方法如心电图和超声心动图在诊断中有作用,但在识别早期亚临床心脏异常患者方面缺乏敏感性。心内膜肌和骨骼肌活检是非常有用的,但侵入性技术不能用于常规随访。心脏和骨骼磁共振成像,由于其进行组织表征的能力,已经成为IIM中心肌和骨骼肌组织变化(水肿、炎症、纤维化)的早期检测和随访的新技术。然而,使用这些方法的临床意义及其成本/效益比需要进一步评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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