Predictors of cardiac involvement in idiopathic inflammatory myopathies
Matilde Bandeira, Eduardo Dourado, Ana Teresa Melo, Patrícia Martins, Vanessa Fraga, José Luís Schifino Ferraro, André Saraiva, Marlene Sousa, Hugo Parente, Catarina Soares, Ana Margarida Correia, Diogo Esperança Almeida, S. P. Dinis, Ana Sofia Pinto, F. Oliveira Pinheiro, Maria Seabra Rato, Tiago Beirão, Beatriz Samões, Bernardo dos Santos, Carolina Mazeda, Ana Teodósio Chícharo, Margarida Faria, Agna Neto, Maria Helena Lourenço, Luísa Brites, Marília Rodrigues, Joana Silva-Dinis, João Madruga Dias, Filipe Araújo, Nádia Vicência do Nascimento Martins, Maura Couto, Ana Valido, María José Santos, Sofia Barreira, João Eurico Fonseca, Raquel Campanilho‐Marques
Abstract
Objectives: Idiopathic inflammatory myopathies (IIM) are a group of rare disorders that can affect the heart. This work aimed to find predictors of cardiac involvement in IIM. Methods: Multicenter, open cohort study, including patients registered in the IIM module of the Rheumatic Diseases Portuguese Register (Reuma.pt/Myositis) until January 2022. Patients without cardiac involvement information were excluded. Myo(peri)carditis, dilated cardiomyopathy, conduction abnormalities, and/or premature coronary artery disease were considered. Results: 230 patients were included, 163 (70.9%) of whom were females. Thirteen patients (5.7%) had cardiac involvement. Compared with IIM patients without cardiac involvement, these patients had a lower bilateral manual muscle testing score (MMT) at the peak of muscle weakness [108.0 ± 55.0 vs 147.5 ± 22.0, p=0.008] and more frequently had oesophageal [6/12 (50.0%) vs 33/207 (15.9%), p=0.009] and lung [10/13 (76.9%) vs 68/216 (31.5%), p=0.001] involvements. Anti-SRP antibodies were more commonly identified in patients with cardiac involvement [3/11 (27.3%) vs 9/174 (5.2%), p=0.026]. In the multivariate analysis, positivity for anti-SRP antibodies (OR 104.3, 95% CI: 2.5-4277.8, p=0.014) was a predictor of cardiac involvement, regardless of sex, ethnicity, age at diagnosis, and lung involvement. Sensitivity analysis confirmed these results. Conclusion: Anti-SRP antibodies were predictors of cardiac involvement in our cohort of IIM patients, irrespective of demographical characteristics and lung involvement. We suggest considering frequent screening for heart involvement in anti-SRP-positive IIM patients.