The Heart in Rheumatic, Autoimmune and Inflammatory Diseases: Pathophysiology, Clinical Aspects and Therapeutic Approaches

The prevalence of autoimmune diseases and rheumatic conditions is constantly increasing. Autoimmune diseases affect approximately 7-10% of the population of the United States, while more than 50,000,000 American adults suffer from some type of arthritis. The Heart in Rheumatic, Autoimmune and Inflammatory Diseases examines the complex mechanisms relating to cardiac diseases from a pathophysiological and clinical point of view. Autoimmune rheumatic diseases can affect the coronary vessels, myocardium, pericardium, heart valves and the conduction system. The diagnosis of these unique cardiac complications necessitates medical awareness and a high index of suspicion. Increased risk of advanced atherosclerosis plays a pivotal role in the development of cardiac diseases in systemic, rheumatic and autoimmune illnesses. Yet, other complex immune medicated mechanisms may contribute to the pathogenesis. Patients' optimal care requires coordination between the primary caregiver, the rheumatologist, immunologist and cardiologist. Screening for cardiovascular risk factors, recognition of high-risk patients and identification of subclinical cardiac conditions are of great importance. Moreover, regulation of inflammation, as well as abnormal immune responses and the initiation of early treatments should be the focus of patient management. A continuous attempt to identify novel therapeutic targets and change the natural history of the underlying disease and its cardiac manifestations is in progress. The book aims at providing the readers with a state of the art collection of up to date information regarding clinically important topics based on experts' perspectives.

This book was a result of an extended coordinated collaboration of one-hundred and fifty-four distinguished scientists from thirty-one countries around the globe.

A review of common, as well as unusual (yet clinically significant) medical cardiac complications of prevalent rheumatic, autoimmune and inflammatory diseases.Focuses on aspects of pathophysiological processes, clinical presentations, screening tests, prognostic implications and novel therapeutic approaches.Presents an up-to-date “level of evidence” and “strengths of recommendations” for suggested therapies and reviews all randomized clinical trials, meta-analyses and other supporting published clinical findings.

Part I. Immune Medicated Cardiac Injury, Accelerated Atherosclerosis and the Study of Cardiac Involvements in Systemic Diseases 1. Pathophysiology of Autoimmunity and Immune-Mediated Mechanisms in Cardiovascular Diseases 2. Organ-Specific Autoimmune Myocardial Diseases: From Pathogenesis to Diagnosis and Management 3. Autoantibodies Directed Against G-Protein-Coupled Receptors in Cardiovascular Diseases: Basics and Diagnostics 4. Immune-Mediated Accelerated Atherosclerosis 5. A Study of Cardiac Function, Atherosclerosis, and Arrhythmogenicity

Part II. Cardiac Manifestations of Inflammatory Arthritis 6. Rheumatoid Arthritis 7. Juvenile Idiopathic Arthritis 8. Spondyloarthritides: Ankylosing Spondylitis, Psoriatic Arthritis, and Reactive Arthritis 9. Polymyalgia Rheumatica

Part III. Cardiac Involvement in Autoimmune and Connective Tissue Diseases 10. Systemic Lupus Erythematosus 11. Neonatal Lupus 12. Sjögren’s Syndrome 13. Systemic Sclerosis 14. Dermatomyositis and Polymyositis

Part IV. Cardiac Manifestations Crystal-Induced Arthritis 15. Gout

Part V. Cardiac Manifestations of Large Vessel Vasculitides 16. Giant Cell Arteritis 17. Takayasu’s Arteritis

Part VI. Cardiac Manifestations of Medium Vessel Vasculitides 18. Polyarteritis Nodosa 19. Kawasaki Disease

Part VII. Cardiac Manifestations of Small Vessel Vasculitides 20. ANCA-Associated Vasculitis: Microscopic Polyangiitis, Eosinophilic Granulomatosis With Polyangiitis (Churg–Strauss Syndrome) and Granulomatosis With Polyangiitis (Wegener’s Granulomatosis)

Part VIII. Cardiac Manifestations of Variable Vessel Vasculitides 21. Behçet’s Disease

Part IX. Post-Infectious Autoimmune Cardiac Diseases 22. Rheumatic Fever and Rheumatic Heart Disease 23. Chagas Cardiomyopathy

Part X. Autoinflammation 24. Familial Mediterranean Fever

Part XI. Therapeutic Approaches: Mechanisms of Action and Cardiac Effects 25. Desirable and Adverse Effects of Antiinflammatory Agents on the Heart 26. The Effects of Immunosuppressive and Cytotoxic Drugs on the Heart 27. Autoantibody-Directed Therapy in Cardiovascular Diseases 28. Cardiac Immunomodulation