Inflammation and Coronary Microvascular Dysfunction in Autoimmune Rheumatic Diseases

Area of Science:

• Rheumatology
• Cardiology
• Immunology

Background:

• Autoimmune rheumatic diseases (ARDs) encompass conditions like SLE, SSc, RA, IIMs, and vasculitis.
• Coronary microvascular dysfunction (CMD) is prevalent in ARDs, contributing to cardiovascular risks.
• Inflammation is a key factor in ARD pathogenesis, impacting both atherosclerosis and CMD.

Purpose of the Study:

• To review the current evidence on CMD occurrence in ARDs.
• To elucidate the role of inflammation in CMD pathogenesis across different ARDs.
• To explore potential therapeutic strategies for CMD in ARDs.

Main Methods:

• Systematic review of existing literature.
• Analysis of studies focusing on CMD in SLE, SSc, RA, IIMs, and systemic vasculitis.
• Evaluation of the impact of inflammation and therapeutic interventions on CMD.

Main Results:

• Inflammation significantly contributes to CMD in SLE and RA, with immunosuppressants/biologics showing efficacy.
• In SSc, CMD is primarily linked to endothelial dysfunction and microvascular ischemia, with calcium-channel blockers offering benefits.
• Limited data exists on CMD in IIMs and systemic vasculitis, necessitating further research.

Conclusions:

• CMD is a significant concern in ARDs, with varying pathogenic mechanisms.
• Targeting inflammation is crucial for managing CMD in SLE and RA.
• Further investigation is required to understand and manage CMD in IIMs and systemic vasculitis.