嗜酸性肉芽肿病合并多血管炎的心脏:进入心脏和血管累及。

IF 5.7 2区 医学 Q1 RHEUMATOLOGY
Current Rheumatology Reports Pub Date : 2022-11-01 Epub Date: 2022-10-04 DOI:10.1007/s11926-022-01087-1
Milena Bond, Filippo Fagni, Michele Moretti, Federica Bello, Allyson Egan, Augusto Vaglio, Giacomo Emmi, Christian Dejaco
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引用次数: 4

摘要

综述目的:对嗜酸性肉芽肿病合并多血管炎(EGPA)累及心脏和血管的病理和临床方面的现有文献进行综述。最近的研究发现:在EGPA中,心脏和血管受累比以前认为的更常见。然而,目前还没有关于这一主题的国际建议。在此,我们总结了关于该主题的现有证据,并提出了EGPA心脏受累的诊断方法。在已发表的研究中,EGPA患者心血管受累的患病率差异很大,闭塞性动脉疾病的患病率为3.1-18.7%,静脉血栓形成的患病率为5.8-30%,心脏受累的患病率为17-92%。EGPA累及心脏与高死亡率相关,尽管表现各异。原则上,心脏的每一个解剖结构都可能受累,egpa相关性心脏病起初可能完全无症状。因此,需要进行仔细的诊断检查,以便及早发现并及时开始治疗。虽然心脏表现在抗中性粒细胞胞浆抗体(ANCA)阴性患者中更为常见,但动脉和静脉血栓形成事件与ANCA状态无关,但与疾病活动密切相关,并在发病时积累。血栓形成事件(主要是静脉)在EGPA中比在普通人群中更为频繁,这在很大程度上导致了发病率,并强调了为被诊断为EGPA的患者制定特定预防策略的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

At the Heart of Eosinophilic Granulomatosis with Polyangiitis: into Cardiac and Vascular Involvement.

At the Heart of Eosinophilic Granulomatosis with Polyangiitis: into Cardiac and Vascular Involvement.

Purpose of review: To provide an overview of existing literature on pathogenetic and clinical aspects of cardiac and vascular involvement in eosinophilic granulomatosis with polyangiitis (EGPA).

Recent findings: In EGPA, cardiac and vascular involvement are more common than previously thought. However, no international recommendations on the topic are available yet. Herein, we summarize the existing evidence on the topic and propose a diagnostic approach for cardiac involvement in EGPA. The prevalence of cardiovascular involvement in patients with EGPA varies greatly among published studies, ranging between 3.1-18.7% for occlusive arterial disease, 5.8-30% for venous thrombosis and 17-92% for heart involvement. Cardiac involvement in EGPA is associated with high mortality even though manifestations are heterogeneous. In principle, every anatomical structure of the heart can be involved, and EGPA-related heart disease may be completely asymptomatic at first. A careful diagnostic work-up for early detection and prompt treatment initiation is therefore required. While cardiac manifestations are more common in anti-neutrophil cytoplasmic antibodies (ANCA)-negative patients, arterial and venous thrombotic events are not linked to ANCA status but correlate closely with disease activity and accumulate at disease onset. Thrombotic events (mainly venous) are considerably more frequent in EGPA than in the general population contributing substantially to morbidity and highlighting the importance of developing specific prevention strategies for patients who are diagnosed with EGPA.

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来源期刊
CiteScore
11.20
自引率
0.00%
发文量
41
期刊介绍: This journal aims to review the most important, recently published research in the field of rheumatology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of rheumatologic conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas such as the many forms of arthritis, osteoporosis and metabolic bone disease, and systemic lupus erythematosus. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also occasionally provided.
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