Clinical analysis of 32 patients with inflammatory myopathy-associated cardiomyopathy

Abstract

Objective To summarize the clinical features and treatment options of patients with inflammatory myopathy associated cardiomyopathy. Methods We respectively analyzed the clinical, electrocardiography and echocardiography results in our hospital from January 1999 to December 2016.This study was a single-center retrospective study of 32 patients with inflammatory myopathy and cardiomyopathy who were hospitalized. Results The 32 patients are involved, including 12 had polymyositis, 10 had dermatomyositis, 8 had overlap syndrome, and 2 had non-specific myositis.The most common symptoms are proximal muscular weakness, pleural/abdominal cavity effusion, pulmonary hypertension, pulmonary interstitial disease, fever and rash.There was no significant correlation between levels of CK, CK-MB, cTnI and left ventricular diameters and systolic function.ECG abnormalities contain frequent ventricular prematures, rapid atrial arrhythmia and low voltage of limb leads, while echocardiography are frequently present with 23 cases of dilated cardiomyopathy, 6 cases of hypertrophic cardiomyopathy, 19 cases of left ventricular diastolic dysfunction, 17 cases of right ventricular systolic function, and 16 cases of pericardial effusion.The mean left ventricular end-diastolic diameter is(54.3±9.2)mm, mean left ventricular ejection fraction is 40.8%±16.2%.All patients start taking prednisone 1-2 mg·kg-1·d-1, 7 cases are prescribed with intravenous immunoglobulin, 12 cases receive corticosteroid pulse therapy.In patients with left ventricular ejection fraction <60%, left ventricular ejection fraction was significantly higher in patients with polymyositis than in patients with dermatomyositis, overlap syndrome and nonspecific myositis. Conclusions Inflammatory myopathy-associated cardiomyopathy is often caused by heart failure and muscular weakness, while other systemic symptoms were atypical.Serum concentrations of muscle enzyme are not significantly correlated with the severity of the illness.The characteristics of the disease include atrial fibrillation, premature ventricular systole in ECG, and dilated cardiomyopathy in echocardiography.Left ventricular ejection fraction was significantly lower in patients with dermatomyositis than in polymyositis. Key words: Inflammatory myopathy; Cardiomyopathies; Heart failure