Abstract
An insidious progression of cardiovascular (CV) involvement is generally associated with rheumatologic diseases and finally regarded as a major source of morbidity and mortality in Juvenile idiopathic arthritis (JIA) patients. JIA could involve all of the cardiac structures, including pericardium, myocardium, endocardium; coronary vessels; valves and conduction system. Development of pericarditis, myocarditis, endocarditis and ventricular dysfunction are not unexpected issues in the progress of JIA. It is essential to ensure a comprehensive follow-up with advanced and up-to-date diagnostic and therapeutic modalities for prevention of CV complications in JIA patients. Since these are all associated with an unfavorable prognosis, it is necessary to detect subclinical cardiac involvement in CV asymptomatic patients, in order to start adequate management and treatment. Furthermore, controlling chronic inflammatory state of JIA by new treatment modalities will also significantly reduce the overall morbidity and mortality related to CV diseases. In this review, we aimed to investigate CV involvement patterns in patients with JIA.
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References
Prakken B, Albani S, Martini A (2011) Juvenile idiopathic arthritis. Lancet 377:2138–2149
Hull RG (1988) Outcome in Juvenile Arthritis. Br J Rheumatol 27:66–71
Thomas E, Symmons DP, Brewster DH, Black RJ, Macfarlane GJ (2003) National study of cause-specific mortality in rheumatoid arthritis, juvenile chronic arthritis, and other rheumatic conditions: a 20 year followup study. J Rheumatol 30:958–965
Oguz D, Ocal B, Ertan Ü, Narin H, Karademir S, Senocak F (2000) Left ventricular diastolic functions in Juvenile Rheumatoid Arthritis. Pediatric Cardiol 21:374–377
Kumar N, Rasheed K, Gallo R, Al-Hales Z, Duran CM (1995) Rheumatic involvement of all four heart valves: preoperative echocardiographic diagnosis and successful surgical management. Eur J Cardiothorac Surg 9:713–714
Turiel M, Sitia S, Atzeni F, Tomasoni L, Gianturco L, Giuffrida M, Colonna VG, Sarzi-Puttini P (2010) The heart in Rheumatoid Arthritis. Autoimmun Rev 9:414–418
Gasparyan AY, Ayvazyan L, Blackmore H, Kitas GD (2011) Writing a narrative biomedical review: considerations for authors, peer reviewers, and editors. Rheumatol Int 31:1409–1417
Brady SR, De Courten B, Reid CM, Cicuttini FM, de Courten MP, Liew D (2009) The role of traditional cardiovascular risk factors among patients with rheumatoid arthritis. J Rheumatol 36:34–40
Coulson EJ, Ng WF, Goff I, Foster HE (2013) Cardiovascular risk in juvenile idiopathic arthritis. Rheumatology 52:1163–1171
Huppertz H, Voigt I, Muller-Scholden J, Sandhage K (2000) Cardiac manifestations in patients with HLA B27-associated juvenile arthritis. Pediatr Cardiol 21:141–147
Goldenberg J, Pessoa AP, Roizenblatt S, Pavoa RMS, Hilario MO, Atra E, Ferraz MB (1990) Cardiac tamponade in juvenile chronic arthritis: report of two cases and review of publications. Ann Rheum Dis 49:549–553
Ozer S, Alehan D, Ozme S, Bakkaloglu A, Söylemezoglu O (1994) Mitral and aortic insufficiency in polyarticular juvenile rheumatoid arthritis. Pediatr Cardiol 15:151–153
Bernstein B, Takahashi M, Hanson V (1984) Cardiac involvement in juvenile rheumatoid arthritis. J Pediatr 85:313–317
Bharti BB, Kumar S, Kapoor A, Agarwal A, Mishra R, Sinha N (2004) Assessment of left ventricular systolic and diastolic function in juvenile rheumatoid arthritis. J Postgrad Med 50:262–265
Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Godenberg J et al (2004) International League of Associations for Rheumatology classification of juvenile idiopathic arthritis. Second revision. Edmonton. J Rheumatol 31:390–392
Alkady EA, Helmy HA, Mohamed-Hussein AA (2012) Assessment of cardiac and pulmonary function in children with juvenile idiopathic arthritis. Rheumatol Int 32:39–46
Sircar D, Ghosh B, Ghosh A, Haldar S (2006) Juvenile idiopathic arthritis. Indian Pediatr 43:429–433
Chen YS, Yang YH, Lin YT, Chiang BL (2004) A patient diagnosed with pauciarticular juvenile rheumatoid arthritis after a mechanical prospective valve replacement due to aortic regurgitation. J Microbial Infect 37:200–202
Lee SJ, Im HY, Schueller WC (2001) HLA-B27 positive juvenile arthritis with cardiac involvement preceding sacroiliac joint changes. Heart 86:19
Goldeli O, Dursun E, Komsuoglu B (1998) Dispersion of ventricular repolarization: a new marker of ventricular arrhythmias in patients with rheumatoid arthritis. J Rheumatol 25:447–450
Svantesson H, Bjorkhem G, Elborgh R (1983) Cardiac involvement in juvenile rheumatoid arthritis: a follow-up study. Acta Paediatr Scand 72:345–350
Miller JJ III, French JW (1977) Myocarditis in juvenile rheumatoid arthritis. Am J Dis Child 131:205–209
Vlahos AP, Alfantaki S, Bechlioulis A, Vakalis K, Michalis LK, Siamopoulou A (2008) Early cardiovascular risk assessment in patients with juvenile idiopathic arthritis. Pediatric Rheumatol 6:1
Gupta M, Rao PS (2004) Cardiac function in juvenile rheumatoid arthritis. Expert’s comments. J Postgrad Med 50(4):266–267
Koca B, Demir T, Kasapcopur O (2015) Use of tissue Doppler and its comparison with other pulse Doppler echocardiography in the evaluation of diastolic functions in patients with active juvenile idiopathic arthritis. Clin Rheumatol 34:1391–1396
Okada T, Shiokawa Y (1975) Cardiac lesions in collagen disease. Jpn Circ J 39:479–484
MacRae VE, Farquharson C, Ahmed SF (2006) The pathophysiology of the growth plate in juvenile idiopathic arthritis. Rheumatology 45:11–19
Birdane A, Korkmaz C, Ata N, Cavuşoğlu Y, Kasifoğlu T, Doğan SM, Gorenek M, Goktekin M, Unalir A, Timuralp B (2007) Tissue Doppler imaging in the evaluation of the left and right ventricular diastolic functions in rheumatoid arthritis. Echocardiogr 24:485–493
Maradit-Kremers H, Nicola PJ, Crowson CS, Ballman KV, Gabriel SE (2005) Cardiovascular death in rheumatoid arthritis: a population-based study. Arthritis Rheum 52:722–732
Pasceri V, Yeh ET (1999) A tale of two diseases: atherosclerosis and rheumatoid arthritis. Circulation 100:2124–2126
Urheim S, Edvarsen T, Torp H, Angelsen B, Smiseth OA (2000) Myocardial strain by Doppler echocardiography: validation of a new method to quantify regional myocardial function. Circulation 102:1158–1164
Maradit-Kremers H, Nicola PJ, Crowson CS, Ballman KV, Gabriel SE (2005) Cardiovascular death in rheumatoid arthritis: a population-based study. Arthritis Rheum 52(3):722–732
Seferovic PM, Ristic AD, Maksimovic R, Simeunovic DS, Ristic GG, Radovanovic G, Seferovic D, Maisch B, Matucci-Cerinic M (2006) Cardiac arrhythmias and conduction disturbances in autoimmune rheumatic diseases. Rheumatology 45:39–42
Urowitz MB, Gladman DD, Abu-Shakra M, Farewell V (1997) Mortality studies in systemic lupus erythematosus. Results from a single center. III. Improved survival over 24 years. J Rheumatol 24:1061–1065
Voskuyl AE (2006) The heart and cardiovascular manifestations in rheumatoid arthritis. Rheumatology (Oxford) 45(Supplement 4):iv4–iv7
Cindas A, Kutsal YG, Tokgozoglu L, Karanfil A (2002) QT dispersion and cardiac involvement in patients with rheumatoid arthritis. Scand J Rheumatol 31:22–26
Yıldırır A, Aksoyek S, Calguneri M, Aytemir K, Kabakci G, Ovunc K, Nazli N, Ozmen F, Oto A, Kes S (2000) QT dispersion as a predictor of arrhythmic events in patients with ankylosing spondylitis. Rheumatology (Oxford) 39(8):875–879
Yavuz B, Atalar E, Karadag O, Tulumen E, Ozer N, Akdogan A, Ertenli I, Kiraz S, Calguneri M, Ozmen F (2007) QT dispersion increases in patients with systemic lupus erythematosus. Clin Rheumatol 26:376–379
Koca B, Kasapcopur O, Bakari S, Celik E, Calay O (2012) QT dispersion and cardiac involvement in patients with juvenile idiopathic arthritis. Rheumatol Int 32:3137–3142
Koca B, Bakari S, Kasapcopur O, Celik E, Oztunc F, Eroglu AG, Saltık L (2012) P wave dispersion in juvenile idiopathic arthritis patients with diastolic dysfunction. Iran J Pediatr 22:512–518
Guler H, Seyfeli E, Sahin G et al (2007) P wave dispersion in patients with rheumatoid arthritis: its relation with clinical and echocardiographic parameters. Rheumatol Int 27(9):813–818
Michelucci A, Bagliani G, Corella A, Pieragnoli P, Porciani MC, Gensini G, Padeletti L (2002) P wave assessment: state of the art update. Card Electrophysiol Rev 6:215–220
Perzanowski C, Ho AT, Jacobson AK (2005) Increased P wave dispersion predicts recurrent atrial fibrillation after cardioversion. J Electrocardiol 38:43–46
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OK designed the concept of paper. BK, OK and SS made the literature research and wrote the paper. AA and KB provided critical input in data collection and processing. All of the authors have analyzed the manuscript, finally.
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Video 1
Color flow recording of a mitral and aortic regurgitation jet obtained from a zoomed view in the four chamber (AVI 4767 kb)
Video 2
Color flow recording of an aortic and mitral regurgitation jet obtained from a zoomed view in parasternal long axis chamber (AVI 5067 kb)
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Koca, B., Sahin, S., Adrovic, A. et al. Cardiac involvement in juvenile idiopathic arthritis. Rheumatol Int 37, 137–142 (2017). https://doi.org/10.1007/s00296-016-3534-z
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DOI: https://doi.org/10.1007/s00296-016-3534-z