FRI0685 PREVALENCE OF CARDIOVASCULAR SYMPTOMS IN PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES – A QUESTIONNAIRE BASED STUDY
Authors: Aleksandra Opinc, Olga Brzezińska, Joanna Makowska
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Cardiovascular involvement in patients with idiopathic inflammatory myopathies (IIM) significantly worsen the prognosis and remain one of the major cause of death<sup>1</sup>. Although it is usually subclinical, symptomatic manifestations are not infrequent and exert considerable impact on the course of IIM<sup>2</sup>. <h3>Objectives</h3> To evaluate the frequency of subjective symptoms indicating cardiovascular involvement in patients with different subtypes of IIM and assess the impact of such ailments on daily living and degree of disability. <h3>Methods</h3> An online questionnaire was created and distributed by means of online support groups to English-speaking patients with IIM. Responders were asked to answer 40 questions concerning subtype and duration of disease, cardiac and musculoskeletal symptoms as well as to fill the Short 2-page Health Assessment Questionnaire (HAQ). Responses of patients with dermatomyositis (DM), polymyositis (PM), inclusion body myositis (IBM) and overlapping syndrome (OS) were analysed statistically. <h3>Results</h3> Questionnaire was completed by 377 responders, among which 38,78% had IBM, 34,07% DM, 16,62% PM and 10,53% OS. Dyspnoea at rest affected at least a few times a month 48,33% patients with PM, 43,09% with DM, 28,95% with OS but only 20,71% with IBM (PM vs OS p=0,057, IBM vs DM p&lt;0,001, IBM vs PM p&lt;0,001). Dyspnoea during daily activities was declared by 55,26%-60,98% of patients with OS, PM and DM, but only 37,14% with IBM (IBM vs OS p=0,04, IBM vs DM p&lt;0,001, IBM vs PM p=0,003). Dyspnoea at exercise was more prevalent in PM and DM groups (respectively 80% and 86,18% vs 71,05% and 52,14% in OS and IBM; DM vs OS p=0,03, IBM vs OS p=0,04, IBM vs DM p&lt;0,001, IBM vs PM p&lt;0,001). Chest pain was noted mostly by participants with DM, OS and PM as in 38,33%-45,53% of them it occurred at least a few times a month, while it affected only 1/5 of responders with IBM (IBM vs OS p=0,002, IBM vs DM p&lt;0,001). Only 37,14% of patients with IBM experienced palpitations while it was declared by 51,67%-63,16% of participants with PM, DM, OS (IBM vs OS p=0,004, IBM vs DM p&lt;0,001, IBM vs PM p=0,056). In contrary to bradycardia, a feeling of too fast heart rate was common, mostly in patients with DM. Ankle oedema and dry cough occurred in respectively 43,90-60% and 43,33-52,03% of participants. Degree of disability, assessed with HAQ was significantly higher in IBM patients. Regardless of myositis subtype dyspnoea during daily activities hindered reaching, dressing and gripping (respectively p=0,015, p=0,03, p&lt;0,01 if comparing patients with and without dyspnoea). Arising, walking and maintaining hygiene was less troublesome for participants with exertional dyspnoea, chest pain, palpitations or tachycardia as compared to patients without those symptoms. <h3>Conclusion</h3> Symptomatic cardiovascular involvement is frequent in patients with IIM. Patients with IBM are less affected by cardiac symptoms yet present the highest degree of disability. Most of cardiac symptoms do not aggravate disability. <h3>References</h3> [1] Diederichsen LP, Cardiovascular involvement in myositis, Curr Opin Rheumatol. 2017Nov;29(6):598-603 [2] Diederichsen, LP, et al., Cardiac Abnormalities in Adult Patients With Polymyositis or Dermatomyositis as Assessed by Noninvasive Modalities, Arthritis Care Res (Hoboken). 2016Jul;68(7):1012-20 <h3>Disclosure of Interests</h3> None declared