Imaging for screening cardiovascular involvement in patients with systemic rheumatologic diseases: more questions...

Area of Science:

• Rheumatology
• Cardiology
• Medical Imaging

Background:

• Cardiovascular involvement in systemic rheumatologic diseases (SRDs) is a significant cause of mortality.
• Current cardiovascular risk scores are inadequate for SRD patients.
• There's a critical need for dedicated cardiovascular risk stratification and screening in asymptomatic SRD individuals.

Purpose of the Study:

• To address the unmet need for a cardiovascular (CV) risk stratification tool and screening algorithm for asymptomatic patients with SRDs.
• To explore the role of imaging parameters in improving CV risk models for SRD patients.
• To determine the necessity of routine cardiac screening in asymptomatic SRD patients.

Main Methods:

• Review of current literature on cardiovascular complications in SRDs.
• Discussion on the potential of echocardiography and carotid ultrasound (CUS) for detecting subclinical CV involvement.
• Consideration of advanced imaging modalities like cardiac MRI, CT angiography, and nuclear imaging.

Main Results:

• Accelerated atherosclerosis is a primary driver of CV events in SRDs.
• Echocardiography and CUS show promise in identifying and monitoring subclinical CV involvement.
• Electrocardiogram (ECG) combined with these imaging techniques could form a basis for screening.

Conclusions:

• A comprehensive approach integrating imaging is crucial for managing CV risk in SRDs.
• Further large-scale studies are required to validate the efficacy of echocardiography and CUS screening protocols in SRD patients.
• Standardized screening protocols using imaging are needed to gather longitudinal data on hard CV outcomes.