Diagnosis and management of myocardial involvement in systemic immune-mediated diseases: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Disease
Abstrakt
The cardiovascular system and in particular the myocardium are often critical targets in Systemic immune-mediated diseases (SIDs), even in asymptomatic patients, leading to a relevant negative burden on prognosis. However, there are at present no studies to recommend cardiac screening in all patients regardless of the clinical suspicion.
Therefore, management of patients with SIDs should always include cardiological screening and follow-up in patients with clinically suspected cardiac involvement. It is hoped that this document will provide a first orientation to cardiologists and non-cardiology physicians in selecting an appropriate multidisciplinary diagnostic workup in SIDs-related myocardial disease, as well as personalised treatment.
Furthermore, it is hoped that cardiologists will actively participate to conception and design of future immunosuppressive/immunomodulatory trials in well-characterized groups of SIDs patients with early/subclinical as well as established myocardial involvement. In fact, at present there is a relative paucity of evidence-based treat-to-target regimens in SIDs patients with myocardial involvement besides empirically driven intensification of conventional immunosuppression.