scholarly journals Arrhythmias and Conduction Disturbances in Autoimmune Rheumatic Disorders

2021 ◽  
Vol 10 (1) ◽  
pp. 17-25
Author(s):  
Sotiris C Plastiras ◽  
Haralampos M Moutsopoulos
Keyword(s):  
Myocardial Fibrosis ◽  
Lupus Erythematosus ◽  
Ventricular Arrhythmias ◽  
Cardiac Involvement ◽  
Muscle Disorders ◽  
Conduction Disturbances ◽  
Autoimmune Rheumatic Diseases ◽  
Ventricular Activity ◽  
Underlying Mechanisms ◽  
Relative Prevalence

Rhythm and conduction disturbances and sudden cardiac death are important manifestations of cardiac involvement in autoimmune rheumatic diseases (ARD), which have a serious impact on morbidity and mortality. While the underlying arrhythmogenic mechanisms are multifactorial, myocardial fibrosis plays a pivotal role. It accounts for a substantial portion of cardiac mortality and may manifest as atrial and ventricular arrhythmias, conduction system abnormalities, biventricular cardiac failure or sudden death. In patients with ARD, myocardial fibrosis is considered to be the hallmark of cardiac involvement as a result of inflammatory process or to coronary artery occlusive disease. Myocardial fibrosis constitutes the pathological substrates for reentrant circuits. The presence of supraventricular extra systoles, tachyarrhythmias, ventricular activity and conduction disturbances are not uncommon in patients with ARDs, more often in systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, inflammatory muscle disorders and anti-neutrophil cytoplasm antibody-associated vasculitis. In this review, the type, the relative prevalence and the underlying mechanisms of rhythm and conduction disturbances in the emerging field of cardiorheumatology are provided.

scholarly journals Prognostic significance of cardiac magnetic resonance-based markers in patients with hypertrophic cardiomyopathy

2021 ◽  
Author(s):  
Zsofia Dohy ◽  
Liliana Szabo ◽  
Attila Toth ◽  
Csilla Czimbalmos ◽  
Rebeka Horvath ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Myocardial Fibrosis ◽  
Ventricular Arrhythmias ◽  
Prognostic Significance ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Icd Therapy ◽  
Lv Mass

AbstractThe prognosis of patients with hypertrophic cardiomyopathy (HCM) varies greatly. Cardiac magnetic resonance (CMR) is the gold standard method for assessing left ventricular (LV) mass and volumes. Myocardial fibrosis can be noninvasively detected using CMR. Moreover, feature-tracking (FT) strain analysis provides information about LV deformation. We aimed to investigate the prognostic significance of standard CMR parameters, myocardial fibrosis, and LV strain parameters in HCM patients. We investigated 187 HCM patients who underwent CMR with late gadolinium enhancement and were followed up. LV mass (LVM) was evaluated with the exclusion and inclusion of the trabeculae and papillary muscles (TPM). Global LV strain parameters and mechanical dispersion (MD) were calculated. Myocardial fibrosis was quantified. The combined endpoint of our study was all-cause mortality, heart transplantation, malignant ventricular arrhythmias and appropriate implantable cardioverter defibrillator (ICD) therapy. The arrhythmia endpoint was malignant ventricular arrhythmias and appropriate ICD therapy. The LVM index (LVMi) was an independent CMR predictor of the combined endpoint independent of the quantification method (p < 0.01). The univariate predictors of the combined endpoint were LVMi, global longitudinal (GLS) and radial strain and longitudinal MD (MDL). The univariate predictors of arrhythmia events included LVMi and myocardial fibrosis. More pronounced LV hypertrophy was associated with impaired GLS and increased MDL. More extensive myocardial fibrosis correlated with impaired GLS (p < 0.001). LVMi was an independent CMR predictor of major events, and myocardial fibrosis predicted arrhythmia events in HCM patients. FT strain analysis provided additional information for risk stratification in HCM patients.

scholarly journals Cardiac involvement in systemic lupus erythematosus not only limited to pericarditis

2011 ◽  
Vol 11 (5) ◽  
pp. 507.2-507
Author(s):  
Pankaj Garg ◽  
Reza Ashrafi ◽  
Ewan McKay ◽  
Gershan Davis
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Cardiac Involvement ◽  
Systemic Lupus

scholarly journals MYOCARDIAL FIBROSIS & VENTRICULAR ARRHYTHMIAS IN ATHLETES

2017 ◽  
Vol 69 (11) ◽  
pp. 2377
Author(s):  
Sabiha Gati ◽  
Aneil Malhotra ◽  
Sanjay Sharma
Keyword(s):  
Myocardial Fibrosis ◽  
Ventricular Arrhythmias

scholarly journals Association of Particulate Matter with Autoimmune Rheumatic Diseases among Adults in South Korea

Rheumatology ◽  
2021 ◽  
Author(s):  
Jun Seok Park ◽  
Seulggie Choi ◽  
Kyuwoong Kim ◽  
Jooyoung Chang ◽  
Sung Min Kim ◽  
...  
Keyword(s):  
Particulate Matter ◽  
Adverse Effects ◽  
South Korea ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Cox Regression ◽  
Statistical Significance ◽  
Cox Regression Analysis ◽  
Autoimmune Rheumatic Diseases ◽  
Quartile Group

Abstract Objective The primary objective is to investigate adverse effects of ambient particulate matter (PM) in various size on the incidence of prevalent autoimmune rheumatic diseases (AIRDs): Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), and Systemic Lupus Erythematosus (SLE). Methods We investigated 230,034 participants in three metropolitan cities of South Korea from the National Health Insurance Service-National Sample Cohort (NHIS-NSC). Starting from January 2010, subjects were followed up until the first event of prevalent AIRDs, death, or December 2013. 2008-2009 respective averages of PM2.5 (&lt; 2.5μm) and PMcoarse (2.5μm to 10μm) were linked with participants’ administrative district codes. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using Cox regression analysis in one- and two-pollutant model. Results Adjusted for age, sex, region, and household income in two-pollutant model, RA incidence was positively associated with 10μg/m³ increment of PM2.5 (aHR = 1.74, 95% CI: 1.06-2.86), but not with PMcoarse (aHR = 1.27, 95% CI: 0.87-1.85). In one-pollutant model, an elevated incidence rate of RA was slightly attenuated (PM2.5 aHR = 1.61, 95% CI: 0.99-2.61; PMcoarse aHR = 1.13, 95% CI: 0.80-1.61), with marginal statistical significance of PM2.5. RA incidence was also higher in 4th quartile group of PM2.5 compared to 1st quartile group (aHR = 1.83, 95% CI: 1.07-3.11). No adverse effects of PM were found on AS or SLE in one- and two-pollutant models. Conclusion Important components of PM10 associated with RA incidence were fine fractions (PM2.5), while no positive association was found between PM and AS or SLE.

Arrhythmias in dialysis patients

2021 ◽  
Vol 4 (57) ◽  
pp. 8-11
Author(s):  
Szymon Warwas ◽  
Marta Jagosz ◽  
Beata Średniawa ◽  
Michał Mazurek ◽  
Ewa Jędrzejczyk-Patej
Keyword(s):  
Cardiovascular Diseases ◽  
Sudden Cardiac Death ◽  
Kidney Disease ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Dialysis Patients ◽  
End Stage Kidney Disease ◽  
Common Cause ◽  
Conduction Disturbances ◽  
End Stage

The most common cause of death among dialysis patients with end-stage kidney disease are cardiovascular diseases. It is estimated that 18-27% of all deaths in dialysis patients are sudden cardiac deaths due to arrhythmias and conduction disturbances. The most common arrhythmias in dialysis patients, often leading to sudden death, are not ventricular arrhythmias but bradyarrhythmias. The article below discusses the most common arrhythmias in dialysis patients and methods of preventing sudden cardiac death in this group of patients.

scholarly journals Clinical Manifestations and Mechanisms of Autoimmune Disease-Related Multiple Cerebral Infarcts

2019 ◽  
Vol 28 (8) ◽  
pp. 1045-1052
Author(s):  
Li-Li Sun ◽  
Wen-Xiong Tang ◽  
Min Tian ◽  
Lu Zhang ◽  
Zun-Jing Liu
Keyword(s):  
Autoimmune Disease ◽  
Autoimmune Diseases ◽  
Lupus Erythematosus ◽  
Transcranial Doppler ◽  
Clinical Manifestations ◽  
Cerebral Infarcts ◽  
Acute Infarction ◽  
Multiple Stroke ◽  
Underlying Mechanisms ◽  
Embolic Signals

It is important to investigate the clinical characteristics and identify the stroke mechanisms of patients with autoimmune disease-related stroke, which are necessary for early etiology diagnosis, accurate treatment and preventive strategies. In this article we retrospectively studied eight cases of acute ischemic stroke associated with autoimmune diseases, and without competing conventional stroke etiologies. The characteristics of stroke (clinical and radiological features), the laboratory tests especially serum D-dimer levels (as a marker of hypercoagulable state), and embolic signals on transcranial Doppler were evaluated for all eight patients. High-resolution magnetic resonance imaging (HRMRI), which can help to evaluate vasculitis was performed in four patients. The possible underlying mechanisms of these cases were discussed based on these manifestations. As a result, autoimmune diseases in our study included systemic lupus erythematosus ( n=5), mixed connective tissue disease ( n=1), central nervous system vasculitis ( n=1), and Takayasu arteritis ( n=1). All eight patients presented with acute infarction lesions in ≥2 vascular territories. Most patients presented with numerous small and medium infarction lesions located in the cortical and subcortical areas. Multiple stroke mechanisms were involved in these cases, including hypercoagulability ( n=4), cardiac embolism ( n=1) and vasculitis ( n=3). Embolic signals could be detected on transcranial Doppler in all three stroke mechanisms. In conclusion, our study revealed the characteristics of autoimmune disease-related stroke. For patients with multiple acute cerebral infarcts within non-single arterial territories, autoimmune disease is an important etiology not to be neglected. Multiple stroke mechanisms were involved in these cases.

scholarly journals Clinical characteristics and outcomes of COVID-19 breakthrough infections among vaccinated patients with systemic autoimmune rheumatic diseases

2021 ◽  
Author(s):  
Claire Cook ◽  
Naomi Patel ◽  
Kristin D'Silva ◽  
Tiffany T-Y Hsu ◽  
Michael DiIorio ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Inflammatory Myopathy ◽  
Vaccination Status ◽  
Antibody Responses ◽  
Molecular Test ◽  
Breakthrough Infection ◽  
Autoimmune Rheumatic Diseases ◽  
Autoimmune Rheumatic Disease ◽  
Systemic Autoimmune Rheumatic Disease ◽  
The Us

Objective To describe the characteristics of COVID-19 vaccine breakthrough infections among systemic autoimmune rheumatic disease (SARD) patients. Methods We identified SARDs patients in a large healthcare system with COVID-19 vaccination at least 14 days prior to a positive SARS-CoV-2 molecular test. Details of the SARD diagnosis, vaccination status, and COVID-19 infection were extracted. Results Of 340 confirmed COVID-19 infections among SARDs patients between December 11th, 2020 (date of first COVID-19 vaccine approval in the US) and July 30th, 2021, we identified 16 breakthrough infections. Seven (44%) received the Pfizer-BioNtech vaccine, five (31%) received the Moderna vaccine, and four (25%) received the Janssen/Johnson & Johnson vaccine. The most common SARDs included rheumatoid arthritis (6, 38%), inflammatory myopathy (3, 19%), and systemic lupus erythematosus (3, 19%). Rituximab (5, 31%), glucocorticoids (4, 25%), and mycophenolate mofetil (4, 25%) were the most frequent treatments. Among the breakthrough infections, 15 (93%) were symptomatic, six (38%) were hospitalized, one (6%) required mechanical ventilation, and two (13%) died. Conclusions Symptomatic, including severe, breakthrough infections were observed in SARDs patients; many were on treatments associated with attenuated antibody responses to vaccination. Further studies are needed to determine the rate of breakthrough infection associated with SARD treatments and other features.

scholarly journals Pentose Phosphate Pathway Regulates Tolerogenic Apoptotic Cell Clearance and Immune Tolerance

2022 ◽  
Vol 12 ◽  
Author(s):  
Dan He ◽  
Qiangdongzi Mao ◽  
Jialin Jia ◽  
Zhiyu Wang ◽  
Yu Liu ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Immune Tolerance ◽  
Lupus Erythematosus ◽  
Pentose Phosphate Pathway ◽  
Apoptotic Cell ◽  
Pentose Phosphate ◽  
Metabolic Reprogramming ◽  
Macrophage Phagocytosis ◽  
Cell Clearance ◽  
Underlying Mechanisms

The efficient removal of apoptotic cells (ACs), a process termed as efferocytosis, is essential for immune homeostasis. While recent work has established an important interplay between efferocytosis and cellular metabolic changing, underlying mechanisms remain poorly known. Here, we discovered that pentose phosphate pathway (PPP) regulates tolerogenic ACs clearance and immune tolerance. ACs decreased levels of PPP-related genes and metabolites in macrophages. AG1, the agonist of PPP, increased the activity of PPP but greatly reduced macrophage phagocytosis of ACs and enhanced the inflammatory response during efferocytosis. miR-323-5p regulated the expression of PPP-related genes and its levels increased during efferocytosis. miR-323-5p inhibitor greatly promoted levels of PPP-related genes, reduced the macrophage phagocytosis of ACs, and increased inflammatory response during efferocytosis, suggesting that miR-323-5p was essential in regulating PPP activity and ACs clearance in macrophages. Correspondingly, the PPP agonist AG1 exacerbated the lupus-like symptoms in the AC-induced systemic lupus erythematosus (SLE) model. Our study reveals that regulating PPP-dependent metabolic reprogramming is critical for tolerogenic ACs phagocytosis and immune tolerance.

scholarly journals Erratum

2017 ◽  
Vol 59 (6) ◽  
pp. NP11-NP11
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Myocardial Fibrosis ◽  
Lupus Erythematosus ◽  
Extracellular Volume ◽  
Strongly Correlated ◽  
Systemic Lupus ◽  
Apparent Diffusion

Wu R, An DA, Hu J, et al. The apparent diffusion coefficient is strongly correlated with extracellular volume, a measure of myocardial fibrosis, and subclinical cardiomyopathy in patients with systemic lupus erythematosus. Acta Radiol 2017. DOI: 10.1177/0284185117717763. In the above-referenced article, the corresponding author was wrongly listed as “Lian-Ming Wu” in the initial OnlineFirst version. The online and print versions have been updated to reflect the correct corresponding author, “Jian-Rong Xu.”

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