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      Imaging for screening cardiovascular involvement in patients with systemic rheumatologic diseases: more questions than answers.

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          Abstract

          Cardiovascular involvement due to systemic rheumatologic diseases (SRDs) remains largely underdiagnosed despite causing excess mortality and limiting the favourable effect of therapeutic developments on survival. Traditional risk scoring systems are poorly calibrated for SRD patients. There is an unmet need to develop a cardiovascular (CV) risk stratification tool and screening algorithm for CV involvement dedicated to asymptomatic patients with SRDs. Even though accelerated atherosclerosis is the most prominent cause of major CV events, a more comprehensive approach is crucial to detect different pathological processes associated with SRDs that are leading to CV complications. In that regard, incorporation of imaging parameters obtained from echocardiography and carotid ultrasound (CUS) might help to improve risk models, to detect and monitor subclinical CV involvement. These two imaging modalities should be an integral part of screening SRD patients with suspicion of CV involvement on top of electrocardiogram (ECG). Cardiac magnetic resonance and multi-slice computerized tomography angiography and nuclear imaging modalities seem very important to complement echocardiography and CUS for further evaluation. However, to answer the question 'Should asymptomatic patients with SRDs undergo screening with echocardiography and CUS on top of ECG?' necessitates large studies performing cardiac screening with a standard approach by using these imaging methods to obtain longitudinal data with hard CV outcomes.

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          Author and article information

          Journal
          Eur Heart J Cardiovasc Imaging
          European heart journal. Cardiovascular Imaging
          Oxford University Press (OUP)
          2047-2412
          2047-2404
          Sep 01 2019
          : 20
          : 9
          Affiliations
          [1 ] Department of Cardiology, Baskent University, 10. Sokak No: 45 Bahcelievler, 06490 Ankara, Turkey.
          [2 ] Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey.
          Article
          5522169
          10.1093/ehjci/jez171
          31230066
          61f2dec9-f756-403f-9022-34cb94a8585f
          History

          cardiovascular complications,risk assessment,rheumatologic diseases,multimodality imaging

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