抗合成酶综合征中的心肌炎:临床特征和诊断方式
Giacomo De Luca1,2, Corrado Campochiaro1,2, Anna Palmisano2,3
1Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy.
Rheumatology (Oxford, England)
|October 5, 2023
概括
肌心炎在抗合成酶综合征 (ASS) 中很常见,通常在初始诊断时出现. 先进的心脏MRI绘图技术显著改善了ASS患者心肌炎的检测.
科学领域:
- 类风湿病学 类风湿病学
- 心脏病学 心脏病学
- 医疗成像医学成像
背景情况:
- 抗合成酶综合征 (ASS) 是一种自身免疫性疾病,具有多样化的临床表现.
- 心肌炎,心肌的炎症,是ASS的一个未被认可的并发症.
- 准确诊断ASS相关心肌炎对于及时干预和管理至关重要.
研究的目的:
- 描述ASS患者心肌炎的临床和仪器特征.
- 评估心脏磁共振成像 (CMRI) 的有效性,使用先进的绘图技术来诊断ASS相关心肌炎.
- 为了比较ASS患者与心肌炎和没有心肌炎之间的临床特征.
主要方法:
- 对ASS患者数据的回顾性分析,重点关注那些被诊断患有心肌炎的人.
- 审查CMRI参数,包括晚期加多增强 (LGE),T2比率,T1映射,细胞外体积 (ECV) 和T2映射.
- 在ASS患者和没有心肌炎之间对临床和实验室发现 (hs-TnT,NT-proBNP,CRP) 的比较.
主要成果:
- 肌心炎在30%的ASS患者中被诊断为心肌炎,通常在临床发病时 (54%).
- 所有ASS心肌炎患者都表现出CMRI异常,ECV (100%),LGE (91%) 和T1/T2映射 (91%) 的增加.
- 与2009年标准 (54.6%) 相比,更新的路易斯湖标准 (2018) 显示肌心炎检测灵敏度 (91.0%) 的提高.
- 患有心肌炎的ASS患者更有可能是男性,并出现发烧,hs-TnT,NT-proBNP和CRP升高.
结论:
- 肌心炎是ASS的频繁和经常早期表现,其特点是炎症表型.
- 新的CMRI映射技术显著提高了ASS中心肌炎的诊断灵敏度.
- 早期发现和治疗ASS相关心肌炎至关重要.
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