Cardiovascular involvement in pediatric systemic autoimmune diseases: the emerging role of noninvasive cardiovascular...

Area of Science:

• Pediatric Rheumatology
• Cardiology
• Autoimmune Diseases

Background:

• Cardiac involvement is common in pediatric systemic autoimmune diseases, presenting diverse symptoms.
• Traditional cardiovascular risk factors do not fully explain heart lesions; chronic inflammation is implicated.
• Commonly affected diseases include rheumatic fever, juvenile idiopathic arthritis, lupus erythematosus, and Kawasaki disease.

Purpose of the Study:

• To highlight the spectrum of cardiac manifestations in pediatric systemic autoimmune diseases.
• To emphasize the role of chronic inflammation in disease pathogenesis.
• To compare the utility of echocardiography and cardiovascular magnetic resonance imaging (CMR) in diagnosis and monitoring.

Main Methods:

• Review of clinical presentations and established knowledge on cardiac involvement in pediatric autoimmune diseases.
• Discussion of noninvasive cardiovascular imaging modalities, focusing on echocardiography and CMR.
• Evaluation of the strengths and limitations of each imaging technique for assessing cardiac lesions.

Main Results:

• Echocardiography is a readily available, cost-effective tool for initial cardiac assessment in children.
• Echocardiography has limitations in detecting disease acuity and the underlying pathophysiology of cardiac lesions.
• Cardiovascular magnetic resonance imaging shows promise for early detection of subclinical disease and detailed myocardial and coronary artery evaluation.

Conclusions:

• Cardiac involvement in pediatric systemic autoimmune diseases requires comprehensive evaluation beyond traditional risk factors.
• Chronic inflammation is a key factor contributing to cardiac pathology in these patients.
• Cardiovascular magnetic resonance imaging offers advanced capabilities for early diagnosis and serial assessment, complementing echocardiography.