Author + information
- Received November 19, 2017
- Revision received May 29, 2018
- Accepted June 28, 2018
- Published online March 13, 2019.
- Ignatios Ikonomidis, MD, PhDa,∗ (, )
- George Makavos, MD, PhDa,
- Pelagia Katsimbri, MD, PhDb,
- Dimitrios T. Boumpas, MD, PhDb,
- John Parissis, MD, PhDa and
- Efstathios Iliodromitis, MD, PhDa
- aSecond Cardiology Department, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Greece
- bRheumatology and Clinical Immunology Unit, Fourth Department of Internal Medicine, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Greece
- ↵∗Address for correspondence:
Dr. Ignatios Ikonomidis, Associate Professor of Cardiology, Second Cardiology Department, Attikon Hospital, National and Kapodistrian University of Athens, Rimini 1, Haidari, 12462 Athens, Greece.
• Rheumatic diseases are inflammatory multisystem diseases with cardiovascular complications that determine prognosis.
• Cardiovascular imaging modalities may offer additive risk stratification over the conventional risk scores in asymptomatic patients.
• Myocardial strain assessment by echocardiography and gadolinium-enhanced cardiac magnetic resonance frequently detects subclinical cardiac dysfunction.
• Whether improvement of surrogate imaging markers by treatment is linked to improved prognosis remains to be determined.
Rheumatic diseases are immune-mediated inflammatory multisystem diseases with frequent cardiovascular manifestations including perimyocarditis, valvular disease, coronary artery disease, heart failure with or without preserved ejection fraction, pulmonary hypertension, aneurysms, and thrombosis. Echocardiography, carotid ultrasonography, cardiac computed tomography, cardiac magnetic resonance imaging, and positron emission tomography are valid diagnostic tools for the detection of the cardiovascular complications of the multisystem diseases that frequently determine prognosis. Furthermore, the findings of these methods may offer additive risk stratification in asymptomatic patients over the conventional risk scores used to assess cardiovascular risk in the primary prevention setting. Finally, the imaging methods offer a unique opportunity to monitor the effects of treatment on atherosclerotic lesions, coronary microcirculatory dysfunction, myocardial inflammation and fibrosis. However, studies are needed to investigate whether improvement of imaging markers by treatment or selection of treatment according to its effects on surrogate imaging markers is linked to improved prognosis.
- cardiac imaging
- cardiovascular risk
- inflammatory diseases
- rheumatoid arthritis
- systemic lupus erythematosus
- systemic sclerosis
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received November 19, 2017.
- Revision received May 29, 2018.
- Accepted June 28, 2018.
- 2019 American College of Cardiology Foundation
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