Cardiac Involvement in Systemic and Local Vasculitides: The Value of Noninvasive Multimodality Imaging

Area of Science:

• Cardiology
• Rheumatology
• Medical Imaging

Background:

• Systemic vasculitides present ongoing cardiovascular risks, despite management advances.
• Cardiac involvement in vasculitis is diverse, including coronary aneurysms, myocarditis, and valvular dysfunction.
• Noninvasive imaging has improved understanding of cardiac manifestations in vasculitis.

Purpose of the Study:

• To review cardiac involvement in systemic vasculitides using a multimodality imaging approach.
• To highlight common cardiac complications and their management in vasculitis.
• To emphasize the importance of early detection and intervention for better prognosis.

Main Methods:

• Review of clinical experiences with cardiac involvement in systemic vasculitides.
• Application of a multi-modality imaging approach including echocardiography, cardiac MRI, PET, and CT angiography.
• Systematic assessment of heart function using ECG, echocardiography (strain, 3D), and cardiac MRI.

Main Results:

• Common cardiac complications include coronary artery aneurysms, acute coronary syndromes, myocarditis, pericarditis, endocarditis, and valvular dysfunction.
• Many cardiac manifestations in vasculitis are clinically silent.
• Multimodality imaging is essential for identifying cardiac involvement and guiding treatment.

Conclusions:

• Early and systematic cardiac assessment using multimodality imaging is vital for patients with systemic vasculitis.
• Timely intervention based on imaging findings improves prognosis.
• Enhanced collaboration between cardiologists and rheumatologists is needed for improved clinical practice and research.