Frontiers in Immunology (Mar 2023)

Predictors of cardiac involvement in idiopathic inflammatory myopathies

  • Matilde Bandeira,
  • Matilde Bandeira,
  • Eduardo Dourado,
  • Eduardo Dourado,
  • Ana Teresa Melo,
  • Ana Teresa Melo,
  • Patrícia Martins,
  • Patrícia Martins,
  • Vanessa Fraga,
  • José Luís Ferraro,
  • André Saraiva,
  • Marlene Sousa,
  • Hugo Parente,
  • Catarina Soares,
  • Ana Margarida Correia,
  • Diogo Esperança Almeida,
  • Sara Paiva Dinis,
  • Ana Sofia Pinto,
  • Filipe Oliveira Pinheiro,
  • Maria Seabra Rato,
  • Tiago Beirão,
  • Beatriz Samões,
  • Bernardo Santos,
  • Carolina Mazeda,
  • Ana Teodósio Chícharo,
  • Margarida Faria,
  • Agna Neto,
  • Maria Helena Lourenço,
  • Luísa Brites,
  • Marília Rodrigues,
  • Joana Silva-Dinis,
  • João Madruga Dias,
  • Filipe C. Araújo,
  • Nádia Martins,
  • Maura Couto,
  • Ana Valido,
  • Maria José Santos,
  • Maria José Santos,
  • Sofia Carvalho Barreira,
  • Sofia Carvalho Barreira,
  • João Eurico Fonseca,
  • João Eurico Fonseca,
  • Raquel Campanilho-Marques,
  • Raquel Campanilho-Marques

DOI
https://doi.org/10.3389/fimmu.2023.1146817
Journal volume & issue
Vol. 14

Abstract

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ObjectivesIdiopathic inflammatory myopathies (IIM) are a group of rare disorders that can affect the heart. This work aimed to find predictors of cardiac involvement in IIM.MethodsMulticenter, open cohort study, including patients registered in the IIM module of the Rheumatic Diseases Portuguese Register (Reuma.pt/Myositis) until January 2022. Patients without cardiac involvement information were excluded. Myo(peri)carditis, dilated cardiomyopathy, conduction abnormalities, and/or premature coronary artery disease were considered.Results230 patients were included, 163 (70.9%) of whom were females. Thirteen patients (5.7%) had cardiac involvement. Compared with IIM patients without cardiac involvement, these patients had a lower bilateral manual muscle testing score (MMT) at the peak of muscle weakness [108.0 ± 55.0 vs 147.5 ± 22.0, p=0.008] and more frequently had oesophageal [6/12 (50.0%) vs 33/207 (15.9%), p=0.009] and lung [10/13 (76.9%) vs 68/216 (31.5%), p=0.001] involvements. Anti-SRP antibodies were more commonly identified in patients with cardiac involvement [3/11 (27.3%) vs 9/174 (5.2%), p=0.026]. In the multivariate analysis, positivity for anti-SRP antibodies (OR 104.3, 95% CI: 2.5-4277.8, p=0.014) was a predictor of cardiac involvement, regardless of sex, ethnicity, age at diagnosis, and lung involvement. Sensitivity analysis confirmed these results.ConclusionAnti-SRP antibodies were predictors of cardiac involvement in our cohort of IIM patients, irrespective of demographical characteristics and lung involvement. We suggest considering frequent screening for heart involvement in anti-SRP-positive IIM patients.

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