Cardiac Involvement in Systemic and Local Vasculitides: The Value of Noninvasive Multimodality Imaging

Despite significant advances in managing sys-temic vasculitides, cardiovascular morbidity, and mor-tality are still of primary concern. Advances in noninvasive imaging have broadened our understanding of the clinical heterogeneity of cardiac involvement in vasculitides. Common cardiovascular complications in primary or secondary vasculitides are; coronary artery aneurysms, acute coronary syndromes, myocarditis, pericarditis, endocarditis, and valvular dysfunction. Echocardiography, cardiac magnetic resonance , posi-tron emission tomography, and computed tomography angiography are essential in identifying cardiac involve-ment and guiding treatment. Here, we present our expe-riences of cardiac involvement in systemic vasculitides, covering most aspects of common cardiac complications based on a multi-modality approach to challenging (real-world) cases. As many cardiac manifestations are clinically silent, heart function should be systemically assessed by a multimodality imaging-based approach, including ECG, serial echocardiograms with strain imaging and 3D, and cardiac magnetic resonance to detect early signs of cardiac manifestations. This enables timely intervention and optimal medical treatment, which is essential for a better prognosis. There is a need for better and closer collaboration in clinical practice and research fields between cardiologists and rheuma-tologists. (Curr Probl Cardiol 2023;48:101718.)

Automated summary

Despite advances in managing systemic vasculitides, cardiovascular morbidity and mortality remain a primary concern. Noninvasive imaging techniques, including echocardiography, cardiac magnetic resonance, positron emission tomography, and computed tomography angiography, play essential roles in identifying and guiding the treatment of cardiac involvement in vasculitides.