Myocardial Involvement in Systemic Autoimmune Rheumatic Diseases

Rheum Dis Clin North Am. 2023 Feb;49(1):45-66. doi: 10.1016/j.rdc.2022.08.002.

Abstract

Systemic autoimmune rheumatic diseases (SARDs) are defined by the potential to affect multiple organ systems, and cardiac involvement is a prevalent but often overlooked sequela. Myocardial involvement in SARDs is medicated by macrovascular disease, microvascular dysfunction, and myocarditis. Systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, eosinophilic granulomatosis with polyangiitis, and sarcoidosis are associated with the greatest risk of myocardial damage and heart failure, though myocardial involvement is also seen in other SARDs or their treatments. Management of myocardial involvement should be disease-specific. Further research is required to elucidate targetable mechanisms of myocardial involvement in SARDs.

Keywords: Cardiomyopathy; Coronary microvascular dysfunction; Myocarditis; Systemic autoimmune rheumatic diseases.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Arthritis, Rheumatoid*
  • Churg-Strauss Syndrome*
  • Disease Progression
  • Granulomatosis with Polyangiitis*
  • Humans
  • Sarcoidosis*