The Heart in Systemic Autoimmune Diseases

2nd Edition, Volume 14 - February 11, 2017
Editors: Fabiola Atzeni, Andrea Dorea, Mike Nurmohamed, Paolo Pauletto
Language: English
Hardback ISBN:
9 7 8 - 0 - 1 2 - 8 0 3 9 9 7 - 7
eBook ISBN:
9 7 8 - 0 - 4 4 4 - 6 3 6 6 9 - 0

The Heart in Systemic Autoimmune Diseases, Second Edition, provides an overview on our current understanding of major complications relating to the heart and autoimmune diseases.… Read more

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The Heart in Systemic Autoimmune Diseases, Second Edition, provides an overview on our current understanding of major complications relating to the heart and autoimmune diseases. It includes the latest information on the new pathogenetic mechanisms involved, along with clinical manifestations of these important comortbidities. Mortality in autoimmune diseases, in particular, rheumatoid arthritis and SLE, has increased when compared with the general population. This excess mortality is largely due to cardiovascular diseases (CVDs)-particularly those of atherosclerotic origin, such as ischemic heart disease-and is gaining recognition in all branches of medicine, from cardiology, to internal medicine, and from rheumatologists to orthopedics.

Chapter 1. Cellular Immunity: A Role for Cytokines

1. Introduction
2. Autoimmunity in Myocarditis
3. Pathogenesis: The Role of Cells and Cytokines

Chapter 2. Organ-Specific Autoimmunity Involvement in Cardiovascular Disease

1. Introduction
2. Post-Myocardial Infarction (Dressler) Syndrome
3. Post-Pericardiotomy Syndrome and Idiopathic Recurrent Acute Pericarditis
4. Rheumatic Carditis
5. Dilated Cardiomyopathy and Myocarditis
6. Idiopathic Tachy and Bradyarrhythmias
7. Systemic Arterial Hypertension

Chapter 3. Neonatal Lupus Syndromes: Pathogenesis and Clinical Features

1. Introduction
2. Epidemiology and Definition of Congenital Complete AVB
3. Etiology/Pathogenesis
4. Risk of Delivering a Child With Complete CHB
5. Clinical Manifestations
6. Treatment
7. Obstetric Management of Pregnancies at Risk of Developing CCHB
8. Prognosis
9. Other Pregnancy Outcomes in Women With Anti-Ro/SSA Antibodies
10. Anti-Ro/SSA Negative CHB

Chapter 4. Subclinical Cardiovascular Damage in Systemic Rheumatic Diseases

1. Introduction
2. Epidemiology and Role of Traditional Risk Factors
3. Subclinical Atherosclerosis
4. Cardiovascular Effects of Pharmacological Treatments

Chapter 5. Atherosclerosis and Autoimmunity

1. Introduction
2. Prevalence and Epidemiology
3. Pathogenesis
4. Clinical Manifestations
5. Diagnostic Investigations
6. Treatment

Chapter 6. Inflammasomes and Inflammatory Cytokines in Early Atherosclerosis

1. Introduction
2. Lipid Dysregulation in Autoimmunity
3. Innate Immunity and Inflammatory Signaling Mechanisms
4. Inflammasomes and IL-1β in Atherogenesis
5. β₂-Glycoprotein I in Atherogenic Innate Immunity
6. Summary and Conclusions

Chapter 7. Treatment of Lipid Metabolism Disturbances in Autoimmune Diseases

1. Introduction
2. Lipid Metabolism Disturbances Relevant for Atherosclerosis and Cardiovascular Risk in Autoimmune Diseases
3. Serum Lipid Level Control in Autoimmune Diseases
4. Lipoprotein Function Modulation in Autoimmune Diseases

Chapter 8. Cardiac Imaging Techniques in Systemic Autoimmune Diseases

1. Introduction
2. Transthoracic Echocardiography
3. Transesophageal Echocardiography
4. Stress Echocardiography
5. Tissue Doppler Imaging
6. Speckle Tracking Echocardiography
7. Myocardial Contrast Echocardiography
8. Usefulness of Biomarkers of Endothelial Dysfunction
9. Carotid Ultrasonography
10. Conclusion

Chapter 9. New Cardiac Imaging Tools and Invasive Techniques in Systemic Autoimmune Diseases (Part II)

1. Introduction
2. Cardiac Magnetic Resonance Imaging
3. Computed Tomography
4. Right Heart Catheterization
5. Endomyocardial Biopsy
6. Conclusion

Chapter 10. Cardiac Diseases in Rheumatoid Arthritis

1. Introduction
2. Atherosclerotic Cardiovascular Disease in Rheumatoid Arthritis
3. Nonatherosclerotic Cardiovascular Disease
4. Conclusion

Chapter 11. Cardiac Involvement in Systemic Lupus Erythematosus

1. Introduction
2. Pericardial Involvement
3. Myocardial Involvement
4. Valvular Involvement
5. Coronary Artery Involvement
6. Conduction Tissue Involvement
7. Conclusions

Chapter 12. Cardiac Involvement in the Antiphospholipid Syndrome

1. Introduction
2. Epidemiology
3. Pathophysiology
4. Clinical Manifestations
5. Diagnostic Procedures
6. Differential Diagnosis
7. Treatment
8. Final Remarks

Chapter 13. Cardiac Involvement in Scleroderma

1. Introduction
2. Evidence for and Prognostic Impact of Clinical Cardiac Involvement
3. Prevalence of Subclinical Cardiac Involvement
4. Ischemic Heart Disease
5. Myocarditis
6. Hypertension
7. Arrhythmias
8. The Future

Chapter 14. Cardiac Involvement in Systemic Vasculitis

1. Introduction
2. Pathogenesis of Vasculitides
3. Cardiovascular Clinical Manifestations in Vasculitides
4. Evolution and Prognostic Factors
5. Treatment
6. Conclusions

Chapter 15. Cardiovascular Involvement in Ankylosing Spondylitis

1. Introduction
2. Cardiovascular Mortality in Ankylosing Spondylitis
3. Vascular Morbidity in Ankylosing Spondylitis
4. Cardiovascular Risk Factors in Ankylosing Spondylitis
5. Aortic Disease in Ankylosing Spondylitis
6. Mitral Valve Involvement in Ankylosing Spondylitis
7. Conduction Abnormalities in Ankylosing Spondylitis
8. Myocardium and Pericardium in Ankylosing Spondylitis
9. Subclinical Vascular Involvement in Ankylosing Spondylitis
10. Treatment and Its Implications in Atherosclerosis in Ankylosing Spondylitis
11. Conclusions

Chapter 16. Cardiovascular Involvement in Psoriatic Arthritis

1. Introduction
2. Epidemiology
3. Etiology/Pathogenesis
4. Clinical Manifestations
5. Diagnostic Investigations
6. Treatment

Chapter 17. Cardiovascular Involvement in Primary Sjögren's Syndrome

1. Introduction
2. Raynaud Phenomenon
3. Cardiovascular Disease
4. Autonomic Cardiovascular Features
5. Pulmonary Arterial Hypertension
6. Arrhythmias
7. Pericarditis
8. Myocarditis

Chapter 18. Gout and Heart Disease: A Two-Way Street?

1. Introduction
2. Gout—Overview
3. Cardiovascular Disease
4. Gout and Traditional Cardiovascular Risk Factors
5. Etiology and Pathogenesis
6. Diagnostic Interventions
7. Treatment
8. Future Perspectives
9. Conclusion

Chapter 19. Heart Involvement in Osteoarthritis

1. Introduction
2. Prerequisites: Pathophysiology of Osteoarthritis
3. Epidemiologic Data: Osteoarthritis and Cardiovascular Diseases, Two Endemic Diseases
4. Association Between Osteoarthritis and Cardiovascular Diseases: Shared Risk Factors
5. Association Between Osteoarthritis and Cardiovascular Diseases: Direct Link Beyond CV Risk Factors
6. Association Between Osteoarthritis and Cardiovascular Diseases: an Epiphenomenon?
7. New Perspectives: The Role of Microbiota
8. Conclusions

Chapter 20. Cardiac Effects of Antirheumatic Drugs

1. Introduction
2. Atherosclerosis and Metabolic Syndrome
3. Other Heart Diseases
4. Recommendations for Cardiovascular Risk Management in Arthritides
5. Conclusions

Fabiola Atzeni

Fabiola Atzeni, MD, PhD is currently Full Professor and Head of the Rheumatology Unit, University of Messina, Messina, Italy. Her clinical and research interest lies in immunotherapies in autoimmune diseases with particular focus on the investigation and management of differential response to biological therapies in rheumatoid arthritis (RA) and Spondyloarthritis (SpA), and cardiovascular aspects of the different rheumatic diseases with particular emphasis on arteriosclerosis. Dr. Atzeni has co-authored over 400 publications in peer-reviewed journals and several book chapters, is a regular reviewer for several international journals. She is involved in several international and national meetings focused on cardiovascular and infection aspects.

Affiliations and expertise

Full Professor and Head of Rheumatology Unit, University of Messina, Messina, Italy

Andrea Dorea

Professor Doria received his medical degree and qualification in Rheumatology from the University of Padua. He was Council member of Italian College of Rheumatology (CRO) between 1999 and 2005 and a Council member of Italian Society of Rheumatology (SIR) from 2007 to 2010 and from 2013 up to now. He is also a member of American College of Rheumatology (ACR).

Professor Doria has organised over ten international conferences on autoimmunity and was involved as “expert” in the EUropean League Against Rheumatism (EULAR) Standing Committee for the development of clinical and therapeutic recommendations: (1) EULAR recommendations for the management of systemic lupus erythematosus (SLE)—Assessment of the SLE patient (2008–2009); (2) EULAR recommendations for the management of SLE Part II—Neuropsychiatric disease (2008–2009); (3) Joint EULAR and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis (2012). Professor Doria is a member of the Lupus Academy Steering Committee co-Chaired the 4th Annual Meeting held in Rome 27th February to 1st March 2015. He will also chair the 10th European Lupus Meeting which will be held in Venice (Italy) 5–8 October 2016. Professor Doria is on the Editorial Boards of several rheumatology and immunology journals, including Lupus, Autoimmunity, Clinical and Experimental Rheumatology, Autoimmunity Reviews, Journal of Autoimmunity, Experimental Biology and Medicine, Rheumatology Reports, Journal Autoimmunity Highlights and Reumatismo (the official journal of Italian Society of Rheumatology).

He has authored over 250 ISI publications on SLE and other connective tissue diseases. These include clinical studies describing new manifestations or subgroup of autoimmune disorders, prognostic risk factors, diagnostic tests and therapeutic interventions as well as immunochemical studies that evaluate autoantibodies, epitopes and complementary epitopes of autoantigens. In addition, he has authored and co-authored three books, over 90 book chapters and conference proceedings, and over 500 abstracts to national and international conferences.

Professor Doria has a long-standing experience in clinical management of connective tissue disease patients. The Unit in which he works is a 3rd referral rheumatology centre, within Italy, for the diagnosis and management of patients affected with systemic connective diseases. In addition, he has expertise in the management and follow-up of pregnant patients with systemic rheumatic diseases. Professor Doria has also trained over 30 students in Rheumatology.

Affiliations and expertise

Professor of Rheumatology and Head of the Unit of Connective Tissue Disease and Rare Rheumatic Diseases, Division of Rheumatology, Department of Medicine, University of Padua, Italy

Mike Nurmohamed

Michael Nurmohamed is Rheumatologist and professor of Rheumatology at the VU University Medical Center, Amsterdam, The Netherlands. His chair has a focus on cardiovascular comorbidities in rheumatic diseases/vascular rheumatology. Furthermore, he is the Head of Rheumatology Research Dept. of Reade where he also works as Rheumatologist and Clinical Research Scientist since 2000. Dr. Nurmohamed has (co)authored over 200 publications in peer-reviewed journals and several book chapters, is a regular reviewer for several international journals and an editorial board member of Annals of Rheumatic Diseases , Arthritis Research Therapy, Journal of Rheumatology and PlosOne. He serves on several (international) boards of cardiovascular scientific societies.

Affiliations and expertise

Professor of Rheumatology at the VU University Medical Center, Amsterdam, Netherlands

Paolo Pauletto

Affiliations and expertise

Professor of Internal Medicine, University of Padova Medical School, Italy

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The Heart in Systemic Autoimmune Diseases

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Institutional subscription on ScienceDirect

Fabiola Atzeni

Andrea Dorea

Mike Nurmohamed

Paolo Pauletto