title: Cardiac involvement in systemic rheumatic diseases: An update.
abstract: The high rates of cardiovascular (CV) mortality and morbidity observed in patients with systemic autoimmune diseases (SADs) cannot be fully explained by traditional atherosclerosis risk factors as standard therapy (i.e. corticosteroids and methotrexate), cytokines and disease activity may all contribute to accelerated atherosclerosis. There is considerable evidence showing that chronic inflammation and immune dysregulation play a pathogenetic role in the development of atherosclerosis in patients with SADs. Chronic inflammation, accelerated atherosclerosis and functional abnormalities of the endothelium suggest that subclinical CV involvement begins soon after the onset of the disease and progresses with disease duration. All cardiac structures may be affected during the course of SADs (valves, the conduction system, the myocardium, endocardium and pericardium, and coronary arteries), and the cardiac complications have a variety of clinical manifestations. As these are all associated with an unfavourable prognosis, it is essential to detect subclinical cardiac involvement in asymptomatic SAD patients, and begin adequate management and treatment early.
authors.affiliation: L. Sacco University Hospital, Milan, Italy. sarzi@tiscali.it
authors.forename: Piercarlo
authors.initials: P
authors.lastname: Sarzi-Puttini
authors.forename: Fabiola
authors.initials: F
authors.lastname: Atzeni
authors.forename: Roberto
authors.initials: R
authors.lastname: Gerli
authors.forename: Elena
authors.initials: E
authors.lastname: Bartoloni
authors.forename: Andrea
authors.initials: A
authors.lastname: Doria
authors.forename: Tatiana
authors.initials: T
authors.lastname: Barskova
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci-Cerinic
authors.forename: Simona
authors.initials: S
authors.lastname: Sitia
authors.forename: Livio
authors.initials: L
authors.lastname: Tomasoni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Turiel
mesh_terms: D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology; D050197:Atherosclerosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology; D042241:Early Diagnosis; D004730:Endothelium, Vascular / Q000276:immunology*; D006801:Humans; D007249:Inflammation; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology