title: Cardiac involvement in adult polymyositis or dermatomyositis: a systematic review.
abstract: BACKGROUND
  To investigate the clinical features of cardiac involvement in polymyositis (PM) or dermatomyositis (DM).
  
  
  OBJECTIVE
  More attention will be focused on the heart in PM/DM as we would have wished, which contribute to improve the prognosis.
  
  
  METHODS
  All articles published in English were retrieved by searching MEDLINE via PubMed (1975-2011). After selecting eligible articles according to the predefined inclusion and exclusion criteria, a systemic review was carried out.
  
  
  RESULTS
  A total of 26 articles were included in this study, which included 1530 patients. The incidence of cardiac involvement was 9% to 72%. Heart failure was the most frequent (32% to 77%) clinical symptom. Among the abnormal electrocardiogram and ultrasonic cardiogram, the incidence of conduction abnormalities, left ventricular diastolic dysfunction, and hyperkinetic left ventricular contraction were 25% to 38.5%, 42%, and 6% to 12%, respectively. The pathologic findings revealed myocardial inflammation, degenerative changes and necrosis similar to that in skeletal muscles. Cardiac manifestations of some patients improved after glucocorticoid and immunosuppressant treatment. Thirty-seven patients (46.3%) died as a direct result of heart disease.
  
  
  CONCLUSIONS
  Heart abnormalities are frequent in patients with PM/DM, most of which were subclinical. The efficacy of glucocorticoids and immunosuppressants is uncertain. Cardiac involvement is a common cause of death.
authors: Graduate School, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100032, China.
authors: Lu
authors: L
authors: Zhang
authors: Guo-chun
authors: GC
authors: Wang
authors: Li
authors: L
authors: Ma
authors: Ning
authors: N
authors: Zu
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D009202:Cardiomyopathies / Q000453:epidemiology; D003882:Dermatomyositis / Q000453:epidemiology* / Q000628:therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D009205:Myocarditis / Q000453:epidemiology; D017285:Polymyositis / Q000453:epidemiology* / Q000628:therapy; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents