Cardiac involvement in systemic rheumatic diseases: An update

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Immunology

Background:

• Systemic autoimmune diseases (SADs) are linked to elevated cardiovascular (CV) mortality and morbidity.
• Traditional atherosclerosis risk factors do not fully explain the increased CV risk in SAD patients.
• Chronic inflammation, immune dysregulation, and disease activity contribute to accelerated atherosclerosis in SADs.

Purpose of the Study:

• To highlight the role of chronic inflammation and immune dysregulation in atherosclerosis development in SAD patients.
• To emphasize that subclinical cardiovascular involvement in SADs begins early and progresses with disease duration.
• To stress the importance of early detection and management of subclinical cardiac involvement in asymptomatic SAD patients.

Main Methods:

• Review of existing evidence on the pathogenetic role of chronic inflammation and immune dysregulation in atherosclerosis in SADs.
• Analysis of the impact of standard therapies, cytokines, and disease activity on accelerated atherosclerosis.
• Examination of the effects of SADs on all cardiac structures and clinical manifestations.

Main Results:

• Chronic inflammation and immune dysregulation are key contributors to atherosclerosis in SADs.
• Subclinical cardiovascular involvement is common, starting early and worsening with disease duration.
• Cardiac structures including valves, myocardium, and coronary arteries can be affected, leading to diverse clinical presentations.

Conclusions:

• Accelerated atherosclerosis in SADs is multifactorial, involving inflammation, immune responses, and disease activity.
• Subclinical cardiac involvement is a significant complication of SADs, associated with poor prognosis.
• Early screening and intervention for cardiac complications in asymptomatic SAD patients are essential for improving patient outcomes.