title: Cardiorheumatology: cardiac involvement in systemic rheumatic disease.
abstract: Autoimmune rheumatic diseases can affect the cardiac vasculature, valves, myocardium, pericardium, and conduction system, leading to a plethora of cardiovascular manifestations that can remain clinically silent or lead to substantial cardiovascular morbidity and mortality. Although the high risk of cardiovascular pathology in patients with autoimmune inflammatory rheumatological diseases is not owing to atherosclerosis alone, this particular condition contributes substantially to cardiovascular morbidity and mortality-the degree of coronary atherosclerosis observed in patients with rheumatic diseases can be as accelerated, diffuse, and extensive as in patients with diabetes mellitus. The high risk of atherosclerosis is not solely attributable to traditional cardiovascular risk factors: dysfunctional immune responses, a hallmark of patients with rheumatic disorders, are thought to cause chronic tissue-destructive inflammation. Prompt recognition of cardiovascular abnormalities is needed for timely and appropriate management, and aggressive control of traditional risk factors remains imperative in patients with rheumatic diseases. Moreover, therapies directed towards inflammatory process are crucial to reduce cardiovascular disease morbidity and mortality. In this Review, we examine the multiple cardiovascular manifestations in patients with rheumatological disorders, their underlying pathophysiology, and available management strategies, with particular emphasis on the vascular aspects of the emerging field of 'cardiorheumatology'.
authors.affiliation: Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Megha
authors.initials: M
authors.lastname: Prasad
authors.affiliation: Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Joerg
authors.initials: J
authors.lastname: Hermann
authors.affiliation: Division of Rheumatology and Department of Health Sciences Research, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Sherine E
authors.initials: SE
authors.lastname: Gabriel
authors.affiliation: Division of Rheumatology, Stanford University, 300 Pasteur Drive, A100 MC5309, Stanford, CA 94305, USA.
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: Weyand
authors.affiliation: Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Mulvagh
authors.affiliation: Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Rekha
authors.initials: R
authors.lastname: Mankad
authors.affiliation: Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Jae K
authors.initials: JK
authors.lastname: Oh
authors.affiliation: Division of Rheumatology and Department of Health Sciences Research, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Matteson
authors.affiliation: Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Amir
authors.initials: A
authors.lastname: Lerman
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications; D050197:Atherosclerosis / Q000209:etiology; D001327:Autoimmune Diseases / Q000150:complications; D002318:Cardiovascular Diseases / Q000209:etiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D012216:Rheumatic Diseases / Q000150:complications*