Cardiac Involvement in Adult Polymyositis or Dermatomyositis: A Systematic Review




To investigate the clinical features of cardiac involvement in polymyositis (PM) or dermatomyositis (DM).


More attention will be focused on the heart in PM/DM as we would have wished, which contribute to improve the prognosis.


All articles published in English were retrieved by searching MEDLINE via PubMed (1975–2011). After selecting eligible articles according to the predefined inclusion and exclusion criteria, a systemic review was carried out.


A total of 26 articles were included in this study, which included 1530 patients. The incidence of cardiac involvement was 9% to 72%. Heart failure was the most frequent (32% to 77%) clinical symptom. Among the abnormal electrocardiogram and ultrasonic cardiogram, the incidence of conduction abnormalities, left ventricular diastolic dysfunction, and hyperkinetic left ventricular contraction were 25% to 38.5%, 42%, and 6% to 12%, respectively. The pathologic findings revealed myocardial inflammation, degenerative changes and necrosis similar to that in skeletal muscles. Cardiac manifestations of some patients improved after glucocorticoid and immunosuppressant treatment. Thirty-seven patients (46.3%) died as a direct result of heart disease.


Heart abnormalities are frequent in patients with PM/DM, most of which were subclinical. The efficacy of glucocorticoids and immunosuppressants is uncertain. Cardiac involvement is a common cause of death. Clin. Cardiol. 2012 doi: 10.1002/clc.22026

The authors have no funding, financial relationships, or conflicts of interest to disclose.