The heart in dermatomyositis and polymyositis

Area of Science:

• Cardiology
• Rheumatology
• Immunology

Background:

• Cardiovascular complications are a significant cause of mortality in patients diagnosed with inflammatory myopathies.
• Clinically apparent cardiac involvement in polymyositis (PM) and dermatomyositis (DM) is infrequent.
• Subclinical cardiac manifestations, particularly conduction abnormalities and arrhythmias detected via electrocardiogram (ECG), are frequently observed.

Purpose of the Study:

• To review the spectrum of cardiac involvement in inflammatory myopathies.
• To elucidate the underlying pathophysiological mechanisms contributing to cardiac manifestations in myositis.

Main Methods:

• Systematic review of literature on cardiovascular manifestations in polymyositis and dermatomyositis.
• Analysis of reported clinical findings, ECG abnormalities, and pathological mechanisms.

Main Results:

• While overt heart failure and coronary artery disease occur, subclinical findings like arrhythmias and conduction defects are more prevalent.
• Complete heart block is a potential complication of conduction abnormalities.
• Myocarditis and small vessel disease of the myocardium are key pathophysiological drivers.

Conclusions:

• Subclinical cardiac involvement is common in myositis, often detected by ECG.
• Understanding these mechanisms is crucial for managing cardiovascular risk in myositis patients.
• Early detection and management of cardiac issues may improve outcomes in inflammatory myopathies.