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Cardiac disease in patients with vasculitis.
Leonhard Binzenhöfer1, Katharina Strauß1, Linus Seifert1
1Medizinische Klinik Und Poliklinik I, Munich, Germany and DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Klinikum Der Universität München, Munich, Germany.
Summary
Cardiac complications in vasculitis are uncommon but risk factors and heart abnormalities are prevalent. Systematic screening and multidisciplinary care are recommended for patients with vasculitis.
Area of Science:
- Cardiology
- Rheumatology
- Systemic Vasculitis
Background:
- Cardiac involvement is a known complication of vasculitides, often linked to poorer patient outcomes.
- Limited data exists on the specific incidence of structural and arrhythmic heart disease in vasculitis patients.
Purpose of the Study:
- To investigate the incidence of structural and arrhythmic heart disease in patients diagnosed with various forms of vasculitis.
- To identify cardiovascular risk factors and cardiac abnormalities in a cohort of vasculitis patients.
Main Methods:
- A single-center study involving 191 patients with giant-cell arteritis (GCA), Takayasu arteritis (TAK), polyarteritis nodosa (PAN), granulomatosis with polyangiitis (GPA), or eosinophilic granulomatosis with polyangiitis (EGPA).
- Cardiac imaging included echocardiography (70%) and cardiac magnetic resonance (11%).
- Analysis of demographic characteristics, baseline comorbidities, and treatment regimens.
Main Results:
- While severe cardiac complications were rare, cardiovascular risk factors like hypertension and dyslipidemia were common, particularly in GCA.
- Cardiac magnetic resonance revealed left ventricular systolic dysfunction and myocardial fibrosis in 33% and 40% of EGPA patients, respectively.
- Acute myocardial infarction occurred in GCA patients; coronary angiography showed intervention needs varied by vasculitis type.
Conclusions:
- A significant proportion of vasculitis patients exhibit cardiovascular risk factors, structural heart abnormalities, and arrhythmias.
- Despite rare severe events, systematic cardiac screening and multidisciplinary management are crucial for vasculitis patients.
- Early detection and management of cardiac involvement can potentially improve outcomes in vasculitis.
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