Title:Cardiovascular Disease in the Systemic Vasculitides
Volume: 18
Issue: 5
Author(s): Stergios Soulaidopoulos*, Anastasia-Vasiliki Madenidou, Dimitrios Daoussis, Konstantinos Melissaropoulos, Sophie Mavrogeni, George Kitas and Theodoros Dimitroulas
Affiliation:
- First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens,Greece
Keywords:
Vasculitis, arteritis, cardiovascular manifestations, takayasu arteritis, kawasaki disease, bechet's disease, ANCA,
cardiac magnetic resonance.
Abstract: The vasculitides are a heterogeneous group of disorders, characterized by inflammatory cell
infiltration and necrosis of blood vessels that cause vascular obstruction or aneurysm formation, affecting
various organs such as lungs, kidneys, skin and joints. Cardiac involvement is commonly encountered
in primary systemic vasculitis and it is associated with increased morbidity and mortality. Depending
on the dominant pathophysiological mechanism, heart complications may manifest in different
ways, including myocardial ischemia due to impaired micro- or macrovascular circulation, progressive
heart failure following valvular heart disease and myocardial dysfunction, (sub) clinical myocarditis,
pericarditis, pulmonary hypertension as well as arteritis of coronary vessels. Beyond cardioprotective
regimens, aggressive immunosuppression reduces the inflammatory burden and modulates the progression
of cardiovascular complications. Perioperative management of inflammation, when surgical treatment
is indicated, improves surgical success rates and postoperative long-term prognosis. We aim to
provide an overview of the pathogenetic, diagnostic and therapeutic principles of cardiovascular involvement
disease in the various forms of systemic vasculitis.