Sore, Hot, and at Risk: The Emerging Specialty of Cardio‐Rheumatology
Brittany Weber, Michael Garshick, Katherine P. Liao, Marcelo F. Di Carli
Abstract
ubor et tumor cum calore et dolore-the cardinal signs of inflammation-first described by Cornelius Celsus-is far from a new concept. Even Galen understood that the balance of health and disease hinged on the body's response to exposures. Inflammation is a response to harmful stimuli and an essential component of the immune response that enables host survival to infection. When systemic immune system activation is overexuberant, any organ system can be adversely impacted. In the cardiovascular system, the impact of inflammation ranges broadly from the initiation or promotion of atherosclerosis to vasculitis, myocarditis, pericarditis, and even heart failure. ecognizing this, along with recent clinical trials showing cardiovascular benefit when targeting the inflammatory pathways (interleukin-1 inhibition in cardiovascular disease, CANTOS: Canakinumab Anti-Inflammatory Thrombosis Outcome Study, 3 and pericarditis, RHAPSODY: Rilonacept Inhibition of Interleukin-1 Alpha and Beta for Recurrent Pericarditis: A Pivotal Symptomatology and Outcomes Study 4 ), as well as upcoming and future trials testing this hypothesis (interleukin-6 inhibition in atherosclerotic disease in ZEUS: A Research Study to Look at How Ziltivekimab Works Compared to Placebo in People With Cardiovascular Disease, Chronic Kidney Disease, and Inflammation 5 ), the time has come to define an evolving subspecialty focused on the intersection of the dysregulated immune response, inflammation, and cardiovascular systemtermed cardio-rheumatology. The expansion of the breadth and depth of cardiovascular medicine has led to an increase in subspecialization.