Cardiac involvement in adult polymyositis or dermatomyositis: a systematic review

Clin Cardiol. 2012 Nov;35(11):686-91. doi: 10.1002/clc.22026. Epub 2012 Jul 30.


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

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

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Asymptomatic Diseases
  • Cardiomyopathies / epidemiology
  • Dermatomyositis / epidemiology*
  • Dermatomyositis / therapy
  • Glucocorticoids / therapeutic use
  • Heart Diseases / diagnosis
  • Heart Diseases / epidemiology*
  • Heart Diseases / mortality
  • Heart Diseases / physiopathology
  • Heart Diseases / therapy
  • Heart Failure / epidemiology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Myocarditis / epidemiology
  • Polymyositis / epidemiology*
  • Polymyositis / therapy
  • Treatment Outcome
  • Ventricular Dysfunction, Left / epidemiology


  • Glucocorticoids
  • Immunosuppressive Agents