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Inflammatory Arthritis and Heart Disease
Santos Castaneda1, Carlos Gonzalez-Juanatey2, Miguel A Gonzalez-Gay3
1Rheumatology Division, Hospital de La Princesa, IIS-Princesa, c/ Diego de Leon 62; 28006 Madrid, Universidad Autonoma de Madrid (UAM), Madrid, Spain.
Insights
Inflammatory joint diseases (IJD) significantly increase the risk of cardiovascular complications, including heart failure and ischemic heart disease, leading to higher mortality. Early detection of cardiac issues in IJD patients is crucial for improved survival.
Area of Science:
- Rheumatology
- Cardiology
- Internal Medicine
Background:
- Inflammatory joint diseases (IJD), such as rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA), are chronic conditions.
- These conditions are characterized by joint inflammation and are associated with a heightened risk of cardiovascular (CV) complications and premature death.
Purpose of the Study:
- To review the most significant cardiovascular manifestations in patients with IJD from a clinical perspective.
- To update current knowledge on CV complications in IJD by analyzing relevant literature.
Main Methods:
- A literature review was conducted using the PubMed database.
- Studies published in English between January 2007 and February 2017 were included.
Main Results:
- Ischemic heart disease and congestive heart failure are the most prevalent and fatal CV complications in IJD.
- Pericarditis, myocarditis, left ventricular diastolic dysfunction, and arrhythmias are also observed, often linked to chronic inflammation and fibrosis.
- Advanced noninvasive tools like cardiac MRI and echocardiography have enhanced understanding of CV disease in IJD.
Conclusions:
- Cardiac manifestations are common in IJD and are a primary driver of increased morbidity and mortality.
- Awareness among clinicians is vital for early diagnosis, which can mitigate CV events and improve patient survival.
Background:
The term inflammatory joint disease (IJD) includes a group of chronic conditions, particularly rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA), with predominant joint involvement and increased risk of cardiovascular (CV) complications and premature mortality.
Objective:
The study aims to review of the most relevant CV manifestations from clinical point of view associated with IJD.
Methods:
To update the current knowledge on CV manifestations in patients with IJD, we review the most relevant literature studies published in English (PubMed database) from January 2007 to February 2017.
Results:
Ischemic heart disease and congestive heart failure are the most relevant complications and those causing higher mortality. Pericarditis and myocarditis may be seen in patients with RA, especially in flares of disease, although they are often asymptomatic. Left ventricular diastolic ventricular dysfunction is an increasing recognized problem. Arrhythmias and cardiac conduction disturbances may be observed in patients with IJD. Chronic inflammation and fibrosis of the cardiac conduction system may be responsible for these complications. Noninvasive diagnostic tools including cardiac magnetic resonance imaging and echocardiography have improved considerably our understanding of the cardiovascular disease in IJD.
Conclusion:
Cardiac manifestations in IJD are frequent and they are the leading cause of an increased morbimortality in IJD. Clinicians would be aware of that, given that early diagnosis of these complications may reduce the frequency of CV events and improve survival of patients with IJD.
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