natriuretic-peptide--brain and Polymyositis

Myocardial involvement (MCI) is known to increase morbidity and mortality in polymyositis (PM) and dermatomyositis (DM). This study aims to investigate whether complicating with ventricular arrhythmia (VA) predicts poor outcomes in patients with PM/DM-related myocardial involvement (PM/DM-MCI).. We reviewed all PM/DM-MCI patients admitted to Peking Union Medical College Hospital from October 1997 to April 2019. VA and the other possible risk factors for the composite endpoint, including death from any cause and rehospitalization for cardiac causes, were analyzed.. A total of 75 PM/DM-MCI patients (44 PM and 31 DM) were enrolled, of which 27 (36%) met the composite endpoint during a median follow-up of 24 months. Independent prognostic factors for the composite endpoint include VA [HR 4.215, 95% CI (1.737, 10.230)], NT-proBNP > 3415 pg/ml [HR 2.606, 95% CI (1.203, 5.646)], interstitial lung disease [HR 2.688, 95% CI (1.209, 5.978)], and anti-cardiac remodelling therapy [HR 0.302, 95% CI (0.115, 0.792)]. The 3-year event-free survival rate of patients without VA was significantly higher than that of patients with VA (63.3% vs 40.7%, P = 0.034). Skin lesions [OR 0.163, 95% CI (0.051, 0.523)] and positive antimitochondrial antibody [OR 3.484, 95% CI (1.192, 10.183)] were independent predictors of VA.. VA provides prognostic insights for PM/DM-MCI patients and predicts poor outcome. Polymyositis and positive antimitochondrial antibody are closely associated with the presence of VA in PM/DM-MCI.

Topics: Adrenergic beta-Antagonists; Adult; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Arrhythmias, Cardiac; Autoantibodies; Cardiomyopathies; Dermatomyositis; Female; Humans; Lung Diseases, Interstitial; Male; Middle Aged; Mineralocorticoid Receptor Antagonists; Mitochondria; Natriuretic Peptide, Brain; Peptide Fragments; Polymyositis; Prognosis; Progression-Free Survival; Proportional Hazards Models; Retrospective Studies; Spironolactone; Survival Rate

Myocardial injury with systemic sclerosis (SSc) causes pericarditis and arrhythmia, and polymyositis-induced muscle inflammation causes myocarditis. We report a rare case of overlap syndrome (SSc and polymyositis) who presented with sudden chest pain secondary to myocardial fibrosis. Although the etiology of chest symptoms in collagen disease was difficult to identify, cardiac magnetic resonance imaging (MRI) revealed not myocarditis but myocardial fibrosis in our case. Synthetic judgement of serum brain natriuretic peptide/ troponin T levels and cardiac MRI is useful in the search for the cause of chest symptoms even in patients with collagen diseases.

Topics: Chest Pain; Fibrosis; Heart; Humans; Magnetic Resonance Imaging; Male; Myocardium; Natriuretic Peptide, Brain; Polymyositis; Scleroderma, Diffuse; Syndrome; Troponin T; Young Adult

To explore the application value of combining brain natriuretic peptide (BNP), creatine phosphokinase (CPK) and echocardiogram in the evaluation of olymyositis-related chronic heart failure (CHF).. Twenty-five polymyositis (PM) patients with CHF (NYHA grade II-IV) were evaluated with New York Heart Association (NYHA) criteria for heart failure. Serum concentration of BNP and CPK were detected by the methods of enzyme linked immunosorbent assay and automatic biochemistry analyzer respectively. Echocardiogram was used to calculate left ventricular ejection fraction (LVEF). Thirty PM patients without CHF were also investiaged as control.. Serum concentrations of BNP, CPK in PM with CHF were significantly higher than those in PM without CHF (P < 0.01). Compared with the level before intervention, BNP concentration in PM with CHF decreased sharply after 14 days therapy (P < 0.05), while the decrease of BNP concentration was not statistically significant (P > 0.05) in PM without CHF after the therapy. The concentration of CPK was much lower in PM patients either with or without CHF after therapy (P < 0.05). Among each group of NYHA grade II-IV, there was statistical significant difference of BNP concentration (P < 0.05). Statistical significant difference of CPK concentration was only found between grade II and grade IV patients. The difference of BNP was not statistical significant between PM patients without CHF but CPK > 2 000 IU/L and PM with grade II CHF. BNP concentration was significantly different between PM patients with LVEF > 40% and those with LVEF < or = 40% (P < 0.05).. BNP is a good marker for PM with CHF and correlates well with LVEF and NYHA grades. In addition, it plays a suggestive role in diagnosing CHF in PM with CPK > 2 000 IU/L.

Topics: Adolescent; Adult; Aged; Creatine Kinase; Echocardiography, Doppler, Color; Female; Heart Failure; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Polymyositis; Young Adult