Skin and maxillary sinus involvement of colon cancer.

OBJECTIVES

To investigate cardiac involvement in patients with anti-melanoma differentiation-associated gene-5 antibody-positive dermatomyositis (MDA5-DM).

METHODS

This prospective study included 37 patients with MDA5-DM and 31 age- and sex-matched healthy controls (HCs). Electrocardiography, echocardiography (ECHO), and cardiac magnetic resonance (CMR) was performed to assess cardiac involvement. Clinical features were compared between patients with and without CMR abnormalities. Logistic regression analysis was used to explore independent risk factors for CMR abnormalities. Six patients with abnormal CMR findings were followed up.

RESULTS

Three patients complained of chest pain, and nine reported palpitations. The incidence of sinus tachycardia and ST-T changes were 13.5%. Premature atrial/ventricular contractions were detected in three patients. Four patients had decreased left ventricular systolic function on ECHO. 24 patients had abnormal CMR mapping results. Patients had significantly higher values in native T1 (p<0.001) and T2 (p=0.007) mapping, compared with HCs. Elevated extracellular volume was detected in 45.9% of the patients. Subgroup analysis showed significantly higher constitutional Visual Analog Scale (VAS) score, cutaneous VAS score, serum NT-proBNP level, and anti-MDA5 antibody titre in patients with abnormal CMR parameters than in those with normal CMR parameters (all p≤0.001). Logistic regression analysis revealed cutaneous VAS score as a risk factor for abnormal CMR (p=0.033). Follow-up of six patients with abnormal CMR findings showed significantly improved CMR mapping parameters post-treatment.

CONCLUSIONS

Subclinical cardiac involvement was predominant in patients with MDA5-DM and can be sensitively detected by CMR. Cardiac involvement is closely correlated with cutaneous lesions and may improve after treatment with prednisone and immunosuppressants.