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Cardiovascular Disease in the Systemic Vasculitides

[ Vol. 18 , Issue. 5 ]

Author(s):

Stergios Soulaidopoulos*, Anastasia-Vasiliki Madenidou, Dimitrios Daoussis, Konstantinos Melissaropoulos, Sophie Mavrogeni, George Kitas and Theodoros Dimitroulas   Pages 463 - 472 ( 10 )

Abstract:


The vasculitides are a heterogeneous group of disorders, characterized by inflammatory cell infiltration and necrosis of blood vessels that cause vascular obstruction or aneurysm formation, affecting various organs such as lungs, kidneys, skin and joints. Cardiac involvement is commonly encountered in primary systemic vasculitis and it is associated with increased morbidity and mortality. Depending on the dominant pathophysiological mechanism, heart complications may manifest in different ways, including myocardial ischemia due to impaired micro- or macrovascular circulation, progressive heart failure following valvular heart disease and myocardial dysfunction, (sub) clinical myocarditis, pericarditis, pulmonary hypertension as well as arteritis of coronary vessels. Beyond cardioprotective regimens, aggressive immunosuppression reduces the inflammatory burden and modulates the progression of cardiovascular complications. Perioperative management of inflammation, when surgical treatment is indicated, improves surgical success rates and postoperative long-term prognosis. We aim to provide an overview of the pathogenetic, diagnostic and therapeutic principles of cardiovascular involvement disease in the various forms of systemic vasculitis.

Keywords:

Vasculitis, arteritis, cardiovascular manifestations, takayasu arteritis, kawasaki disease, bechet's disease, ANCA, cardiac magnetic resonance.

Affiliation:

First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Centre of Rheumatology, University College London, London, Department of Rheumatology, Patras University Hospital, Faculty of Medicine, University of Patras Medical School, Patras, Department of Rheumatology, Patras University Hospital, Faculty of Medicine, University of Patras Medical School, Patras, Onassis Cardiac Surgery Center, Athens, Department of Rheumatology, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, West Midlands, Fourth Department of Internal Medicine, Hippokration University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki

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