Cardiac Abnormalities in Adult Patients With Polymyositis or Dermatomyositis as Assessed by Noninvasive Modalities.
Cardiac events are a major cause of death in patients with idiopathic inflammatory myopathies. The study objective was in a controlled setting to describe cardiac abnormalities by noninvasive methods in a cohort of patients with polymyositis (PM) or dermatomyositis (DM) and to identify predictors for cardiac dysfunction.



In a cross-sectional study, 76 patients with PM/DM and 48 matched healthy controls (HCs) were assessed by serum levels of cardiac troponin I, electrocardiography, Holter monitoring, echocardiography with tissue Doppler imaging, and quantitative cardiac (99m) Tc-pyrophosphate ((99m) Tc-PYP) scintigraphy.



Compared to HCs, patients with PM/DM more frequently had left ventricular diastolic dysfunction (LVDD) (12% versus 0%; P = 0.02) and longer QRS and QT intervals (P = 0.007 and P < 0.0001, respectively). In multivariate analysis, factors associated with LVDD were age (P = 0.001), disease duration (P = 0.004), presence of myositis-specific or -associated autoantibodies (P = 0.05), and high cardiac (99m) Tc-PYP uptake (P = 0.006). In multivariate analysis of the pooled data for patients and HCs, a diagnosis of PM/DM (P < 0.0001) was associated with LVDD.



Patients with PM or DM had an increased prevalence of cardiac abnormalities compared to HCs. LVDD was a common occurrence in PM/DM patients and correlated to disease duration. In addition, the association of LVDD with myositis-specific or -associated autoantibodies and high cardiac (99m) Tc-PYP uptake supports the notion of underlying autoimmunity and myocardial inflammation in patients with PM/DM.
Odense University Hospital, Odense, Denmark.
L P
LP
Diederichsen
Odense University Hospital, Odense, Denmark.
J A
JA
Simonsen
Odense University Hospital, Odense, Denmark.
A C
AC
Diederichsen
Odense University Hospital, Odense, Denmark.
S
S
Hvidsten
Odense University Hospital, Odense, Denmark.
M
M
Hougaard
Odense University Hospital, Odense, Denmark.
P
P
Junker
Aarhus University Hospital, Aarhus, Denmark.
K
K
Søndergaard
Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.
I E
IE
Lundberg
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
N
N
Tvede
Odense University Hospital, Odense, Denmark.
N C F
NC
Sandgaard
Vejle Hospital, Vejle, Denmark.
A F
AF
Christensen
Gentofte University Hospital, Hellerup, Denmark.
L
L
Dreyer
Odense University Hospital, Odense, Denmark.
S
S
Kay
Odense University Hospital, Odense, Denmark.
K S
KS
Eskerud
Odense University Hospital, Odense, Denmark.
H
H
Petersen
Esbjerg Hospital, Esbjerg, Denmark.
L
L
Ejstrup
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
S
S
Jacobsen
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D003882:Dermatomyositis / Q000150:complications*; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D017285:Polymyositis / Q000150:complications; D015995:Prevalence; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D019210:Troponin I