Cardiac abnormalities assessed by non-invasive techniques in patients with newly diagnosed idiopathic inflammatory myopathies

TY - JOUR

T1 - Cardiac abnormalities assessed by non-invasive techniques in patients with newly diagnosed idiopathic inflammatory myopathies

AU - Diederichsen, Louise Pyndt

AU - Simonsen, Jane Angel

AU - Diederichsen, Axel Cosmus Pyndt

AU - Kim, Won Yong

AU - Hvidsten, Svend

AU - Hougaard, Mikkel

AU - Junker, Peter

AU - Lundberg, Ingrid E

AU - Petersen, Henrik

AU - Hansen, Esben Søvsø Szocska

AU - Eskerud, Karl Sannes

AU - Kay, Susan Due

AU - Jacobsen, Søren

PY - 2015/9/8

Y1 - 2015/9/8

N2 - Objective: Knowledge of cardiac involvement in idiopathic inflammatory myopathies (IIM) is limited, especially in the early stage of disease. The objective of the present study was to perform a controlled evaluation of cardiac abnormalities in newly diagnosed, untreated patients with idiopathic inflammatory myopathies (IIM) by means of non-invasive techniques. Methods: Fourteen patients with IIM (8 polymyositis, 4 dermatomyositis, 2 cancer-associated dermatomyositis) and 14 gender- and age- matched healthy control subjects were investigated. Participant assessments included a cardiac questionnaire, cardiac troponin-I (TnI), electrocardiogram (standard 12-lead and 48-h Holter monitoring), echocardiography with tissue Doppler measures, cardiac magnetic resonance (CMR) imaging with T2 mapping and semi-quantitative 99mtechnetium pyrophosphate (99mTc-PYP) scintigraphy. Results: Dyspnoea was present in 8 (57%) of the patients compared to none of the controls (p<0.01). Median levels of TnI in patients and controls were 20 ng/L and 6 ng/L, respectively (p=0.06). QTc intervals were prolonged in the patient group (p=0.01). Two patients had systolic dysfunction, and one diastolic dysfunction. The myocardial 99mTc-PYP uptake and CMR results differed between patients and controls, albeit not with statistical significance. Overall, cardiac abnormalities were demonstrated in 9 (64%) of the patients versus 2 (14%) of the controls (p=0.02). Conclusion: Cardiac abnormalities assessed by TnI, ECG or imaging modalities were significantly more common in newly diagnosed, treatment naïve patients with IIM compared to healthy control subjects. These abnormalities, although subclinical, may indicate that myocardial involvement is common in patients and calls for larger controlled studies and further investigations of the prognostic implications of this finding.

AB - Objective: Knowledge of cardiac involvement in idiopathic inflammatory myopathies (IIM) is limited, especially in the early stage of disease. The objective of the present study was to perform a controlled evaluation of cardiac abnormalities in newly diagnosed, untreated patients with idiopathic inflammatory myopathies (IIM) by means of non-invasive techniques. Methods: Fourteen patients with IIM (8 polymyositis, 4 dermatomyositis, 2 cancer-associated dermatomyositis) and 14 gender- and age- matched healthy control subjects were investigated. Participant assessments included a cardiac questionnaire, cardiac troponin-I (TnI), electrocardiogram (standard 12-lead and 48-h Holter monitoring), echocardiography with tissue Doppler measures, cardiac magnetic resonance (CMR) imaging with T2 mapping and semi-quantitative 99mtechnetium pyrophosphate (99mTc-PYP) scintigraphy. Results: Dyspnoea was present in 8 (57%) of the patients compared to none of the controls (p<0.01). Median levels of TnI in patients and controls were 20 ng/L and 6 ng/L, respectively (p=0.06). QTc intervals were prolonged in the patient group (p=0.01). Two patients had systolic dysfunction, and one diastolic dysfunction. The myocardial 99mTc-PYP uptake and CMR results differed between patients and controls, albeit not with statistical significance. Overall, cardiac abnormalities were demonstrated in 9 (64%) of the patients versus 2 (14%) of the controls (p=0.02). Conclusion: Cardiac abnormalities assessed by TnI, ECG or imaging modalities were significantly more common in newly diagnosed, treatment naïve patients with IIM compared to healthy control subjects. These abnormalities, although subclinical, may indicate that myocardial involvement is common in patients and calls for larger controlled studies and further investigations of the prognostic implications of this finding.

KW - Adult

KW - Aged

KW - Biomarkers

KW - Case-Control Studies

KW - Dermatomyositis

KW - Diagnostic Imaging

KW - Dyspnea

KW - Electrocardiography, Ambulatory

KW - Female

KW - Heart Diseases

KW - Humans

KW - Male

KW - Middle Aged

KW - Polymyositis

KW - Predictive Value of Tests

KW - Surveys and Questionnaires

KW - Troponin I

KW - Ventricular Dysfunction

KW - Ventricular Function

M3 - Journal article

C2 - 26343166

SN - 0392-856X

VL - 33

SP - 706

EP - 714

JO - Clinical and Experimental Rheumatology

JF - Clinical and Experimental Rheumatology

IS - 5

ER -