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Updated: Feb 15, 2026
In Silico Clinical Trials for Cardiovascular Disease
Published on: May 27, 2022
Cardiovascular involvement in systemic rheumatic diseases: An integrated view for the treating physicians
Kwang Seob Lee1, Andreas Kronbichler2, Michael Eisenhut3
1Yonsei University College of Medicine, Seoul, Republic of Korea.
Insights
Cardiovascular disease is a major concern in rheumatic diseases, often progressing silently due to chronic inflammation. Early diagnosis and intensive management of risk factors are crucial for better patient outcomes.
Area of Science:
- Rheumatology
- Cardiology
- Immunology
Background:
- Systemic autoimmune diseases frequently impact multiple organs, including the cardiovascular system.
- Cardiovascular involvement in rheumatic diseases encompasses myocardium, pericardium, vessels, conduction, and valves, contributing to increased mortality.
- Chronic inflammation in rheumatic diseases accelerates atherosclerosis and can lead to silent heart failure and arrhythmias.
Purpose of the Study:
- To review the current evidence on cardiovascular involvement in rheumatic diseases.
- To highlight the importance of early diagnosis and management of cardiovascular risk factors.
- To discuss the role of immunosuppressive agents in cardiovascular health within rheumatic disease patients.
Main Methods:
- Literature review focusing on cardiovascular manifestations in rheumatic diseases.
- Analysis of disease-specific factors influencing cardiovascular health.
- Discussion of traditional cardiovascular risk factors and their management.
- Brief overview of immunosuppressive drug cardiotoxicity.
Main Results:
- Disease-specific factors (duration, severity, activity, antibodies) significantly impact cardiovascular health.
- Traditional risk factors like hypercholesterolemia and hypertension require intensive management.
- Immunosuppressive agents control rheumatic diseases, but their direct cardioprotective effects require further definition.
- Cardiotoxicity from immunosuppressive drugs is rare but noted.
Conclusions:
- Cardiovascular involvement is a critical, often silent, complication of rheumatic diseases.
- Integrated management addressing both disease activity and cardiovascular risk factors is essential.
- Further research is needed to clarify the cardioprotective role of immunosuppressive therapies.
Abstract:
Systemic autoimmune diseases can affect various kinds of organs including the kidney, the skin, soft tissue and the bone. Among others, cardiovascular involvement in rheumatic diseases has been shown to affect myocardium, pericardium, cardiac vessels, conduction system and valves, eventually leading to increased mortality. In general, underlying chronic inflammation leads to premature atherosclerosis, but also other manifestations such as arrhythmia and heart failure may have a 'silent' progress. Traditional cardiovascular risk factors play a secondary role, while disease-specific factors (i.e. disease duration, severity, antibody positivity, persistent disease activity) can directly influence the cardiovascular system. Therefore, early diagnosis is critical to optimize management and to control inflammatory activity and recent data suggest that risk factors (i.e. hypercholesterolemia and hypertension) need intensive treatment as well. With the advent of immunosuppressive agents, most rheumatic diseases are well controlled on treatment, but information related to their cardioprotective efficacy is not well-defined. In this review, we focus on cardiovascular involvement in rheumatic diseases and highlight current evidence which should be of help for the treating physicians. Moreover, cardiotoxicity of immunosuppressive drugs is a rare issue and such potential adverse events will be briefly discussed.
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