{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T18:21:20Z","timestamp":1793816480553,"version":"4.6.1"},"reference-count":68,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T00:00:00Z","timestamp":1559779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Introduction: Patients with inflammatory rheumatic diseases have an increased risk of developing cardiovascular manifestations. The high risk of cardiovascular pathology in these patients is not only due to traditional cardiovascular risk factors (age, gender, family history, smoking, sedentary lifestyle, cholesterol), but also to chronic inflammation and autoimmunity. Aim: In this review, we present the mechanisms of cardiovascular comorbidities associated with inflammatory rheumatic diseases, as they have recently been reported by different authors, grouped in electrical abnormalities, valvular, myocardial and pericardial modifications and vascular involvement. Methods: We conducted a systematic search of published literature on the following online databases: EBSCO, ScienceDirect, Scopus and PubMed. Searches were limited to full-text English-language journal articles published between 2010 and 2017 using the following key words: heart, systemic inflammation, autoimmunity, rheumatic diseases and disease activity. After the primary analysis we included 50 scientific articles in this review. Results: The results showed that cardiac manifestations of systemic inflammation can occur frequently with different prevalence in rheumatoid arthritis (RA), systemic lupus erythematosus(SLE), systemic sclerosis(SSc) and ankylosing spondylitis(AS). Rheumatologic diseases can affect the myocardium, cardiac valves, pericardium, conduction system and arterial vasculature. Conclusions: Early detection, adequate management and therapy of specific cardiac involvement are essential in rheumatic disease. Electrocardiographic and echocardiographic evaluation should be performed as routine investigations in patients with inflammatory rheumatic diseases.<\/jats:p>","DOI":"10.3390\/medicina55060249","type":"journal-article","created":{"date-parts":[[2019,6,7]],"date-time":"2019-06-07T03:56:31Z","timestamp":1559879791000},"page":"249","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Heart Involvement in Inflammatory Rheumatic Diseases: A Systematic Literature Review"],"prefix":"10.3390","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9814-9561","authenticated-orcid":false,"given":"Florina","family":"Buleu","sequence":"first","affiliation":[{"name":"Departament of Cardiology, Faculty of Medicine, University of Medicine and Pharmacy \u201cVictor Babe\u0219\u201d, Timi\u0219oara 300041, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0874-662X","authenticated-orcid":false,"given":"Elena","family":"Sirbu","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Special Motricity, West University of Timi\u0219oara, Timi\u0219oara 300223, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru","family":"Caraba","sequence":"additional","affiliation":[{"name":"Departament of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy \u201cVictor Babe\u0219\u201d, Timi\u0219oara 300041, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Dragan","sequence":"additional","affiliation":[{"name":"Departament of Cardiology, Faculty of Medicine, University of Medicine and Pharmacy \u201cVictor Babe\u0219\u201d, Timi\u0219oara 300041, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,6,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1038\/nrrheum.2015.112","article-title":"Cardiovascular comorbidity in rheumatic diseases","volume":"11","author":"Nurmohamed","year":"2015","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.autrev.2016.07.026","article-title":"Cardiovascular risk assessment in patients with rheumatoid arthritis: The relevance of clinical, genetic and serological markers","volume":"15","author":"Castaneda","year":"2016","journal-title":"Autoimmun. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1038\/nrcardio.2014.206","article-title":"Cardiorheumatology: Cardiac involvement in systemic rheumatic disease","volume":"12","author":"Prasad","year":"2015","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/j.berh.2016.10.006","article-title":"Cardiovascular disease in inflammatory rheumatic diseases","volume":"30","author":"Castaneda","year":"2016","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_5","first-page":"367359","article-title":"Cardiovascular involvement in autoimmune diseases","volume":"2014","year":"2014","journal-title":"Biomed Res. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"iv39","DOI":"10.1093\/rheumatology\/kel315","article-title":"Cardiac arrhythmias and conduction disturbances in autoimmune rheumatic diseases","volume":"45","author":"Maisch","year":"2006","journal-title":"Rheumatology (Oxf. Engl.)"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1161\/CIRCULATIONAHA.110.959734","article-title":"Risk stratification for arrhythmic sudden cardiac death: Identifying the roadblocks","volume":"123","author":"Goldberger","year":"2011","journal-title":"Circulation"},{"key":"ref_8","first-page":"77","article-title":"Long-term prognosis in patients with rheumatoid arthritis depending on baseline variability of cardiac rhythm","volume":"77","author":"Parnes","year":"2005","journal-title":"Terapevticheskiiarkhiv"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1007\/s00296-003-0357-5","article-title":"Heart rate variability in patients with rheumatoid arthritis","volume":"24","author":"Dursunoglu","year":"2004","journal-title":"Rheumatol. Int."},{"key":"ref_10","first-page":"536","article-title":"Antibodies to cardiac conducting tissue and abnormalities of cardiac conduction in rheumatoid arthritis","volume":"53","author":"Villecco","year":"1983","journal-title":"Clin. Exp. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/BF01450894","article-title":"Echocardiographic findings. 24-hour electrocardiographic Holter monitoring in patients with rheumatoid arthritis according to Steinbrocker\u2019s criteria, functional index, value of Waaler-Rose titre and duration of disease","volume":"17","author":"Wislowska","year":"1998","journal-title":"Clin. Rheumatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.jbspin.2010.01.001","article-title":"Usefulness of routine electrocardiography for heart disease screening in patients with spondyloarthropathy or rheumatoid arthritis","volume":"77","author":"Goulenok","year":"2010","journal-title":"Jt. Bone Spine Rev. Du Rhum."},{"key":"ref_13","first-page":"155","article-title":"Importance of Electrocardiogram for Detection of Preclinical Abnormalities in Patients with Rheumatoid Arthritis without Cardiovascular Events","volume":"4","author":"Sarr","year":"2015","journal-title":"J. Arthritis"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1093\/europace\/eut290","article-title":"Evidence for cardiac safety and antiarrhythmic potential of chloroquine in systemic lupus erythematosus","volume":"16","author":"Teixeira","year":"2014","journal-title":"Europace"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1007\/s00296-009-0889-4","article-title":"Systolic and diastolic heart function in SLE patients","volume":"29","author":"Wislowska","year":"2009","journal-title":"Rheumatol. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.autrev.2005.11.002","article-title":"Connective tissue diseases and cardiac rhythm disorders: An overview","volume":"5","author":"Lazzerini","year":"2006","journal-title":"Autoimmunity Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"427","DOI":"10.14740\/jocmr2488w","article-title":"Cardiac Involvement in Ankylosing Spondylitis","volume":"8","author":"Ozkan","year":"2016","journal-title":"J. Clin. Med. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"463620","DOI":"10.5402\/2012\/463620","article-title":"Cardiac manifestations of rheumatological conditions: A narrative review","volume":"2012","author":"Owlia","year":"2012","journal-title":"ISRN Rheumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/1529-0131(200104)45:2<129::AID-ANR164>3.0.CO;2-K","article-title":"Cardiac manifestations of rheumatoid arthritis: A case-control transesophageal echocardiography study in 30 patients","volume":"45","author":"Guedes","year":"2001","journal-title":"Arthritis Rheum."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/j.amjmed.2007.01.024","article-title":"Libman-Sacks endocarditis in systemic lupus erythematosus: Prevalence, associations, and evolution","volume":"120","author":"Moyssakis","year":"2007","journal-title":"Am. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.repc.2012.02.005","article-title":"Valvular lesions in patients with systemic lupus erythematosus and antiphospholipid syndrome: An old disease but a persistent challenge","volume":"31","author":"Ferreira","year":"2012","journal-title":"Rev. Port. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1001\/archinte.1979.03630470087026","article-title":"The echocardiogram in scleroderma endocarditis of the mitral valve","volume":"139","author":"Kinney","year":"1979","journal-title":"Arch. Intern. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"993","DOI":"10.4330\/wjc.v6.i9.993","article-title":"Cardiac manifestations in systemic sclerosis","volume":"6","author":"Lambova","year":"2014","journal-title":"World J. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"215","DOI":"10.4103\/0019-5154.44801","article-title":"Cardiac Involvement in patients of Systemic Sclerosis","volume":"53","author":"Ahmad","year":"2008","journal-title":"Indian J. Dermatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/S0735-1097(98)00393-3","article-title":"Aortic root disease and valve disease associated with ankylosing spondylitis","volume":"32","author":"Roldan","year":"1998","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1002\/art.21560","article-title":"Contribution of congestive heart failure and ischemic heart disease to excess mortality in rheumatoid arthritis","volume":"54","author":"Nicola","year":"2006","journal-title":"Arthritis Rheum."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.amjmed.2003.09.039","article-title":"Heart failure in rheumatoid arthritis: Rates, predictors, and the effect of anti-tumor necrosis factor therapy","volume":"116","author":"Wolfe","year":"2004","journal-title":"Am. J. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1053\/j.semarthrit.2003.09.011","article-title":"Echocardiographic and Doppler findings in long-term treated rheumatoid arthritis patients without clinically evident cardiovascular disease","volume":"33","author":"Testa","year":"2004","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/S0002-9343(02)01223-8","article-title":"Myocarditis in systemic lupus erythematosus","volume":"113","author":"Wijetunga","year":"2002","journal-title":"Am. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1161\/CIRCULATIONAHA.106.673319","article-title":"Systemic lupus erythematosus predicts increased left ventricular mass","volume":"116","author":"Pieretti","year":"2007","journal-title":"Circulation"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"iii45","DOI":"10.1093\/rheumatology\/kep110","article-title":"Cardiac complications of systemic sclerosis","volume":"48","author":"Kahan","year":"2009","journal-title":"Rheumatology (Oxf.)"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2346","DOI":"10.1161\/CIRCULATIONAHA.106.678334","article-title":"Cardiovascular manifestations of rheumatologic diseases","volume":"116","author":"Roman","year":"2007","journal-title":"Circulation"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1056\/NEJM198401193100302","article-title":"Physiologic abnormalities of cardiac function in progressive systemic sclerosis with diffuse scleroderma","volume":"310","author":"Follansbee","year":"1984","journal-title":"N. Engl. J. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1093\/rheumatology\/keg371","article-title":"Carotid and femoral arterial wall mechanics in scleroderma","volume":"42","author":"Cheng","year":"2003","journal-title":"Rheumatology (Oxf.)"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3294","DOI":"10.1002\/art.30581","article-title":"Increased risk of cardiovascular and cerebrovascular diseases in individuals with ankylosing spondylitis: A population-based study","volume":"63","author":"Szabo","year":"2011","journal-title":"Arthritis Rheum."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1093\/rheumatology\/keu337","article-title":"Left ventricular myocardial dysfunction and premature atherosclerosis in patients with axial spondyloarthritis","volume":"54","author":"Chen","year":"2015","journal-title":"Rheumatology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"18","DOI":"10.7861\/clinmedicine.1-1-18","article-title":"Cardiac involvement in rheumatoid disease","volume":"1","author":"Kitas","year":"2001","journal-title":"Clin. Med. (Lond.)"},{"key":"ref_38","first-page":"286","article-title":"Extra-articular Manifestations in Rheumatoid Arthritis","volume":"5","author":"Cojocaru","year":"2010","journal-title":"Maedica"},{"key":"ref_39","first-page":"809","article-title":"Cardiovascular disorders and rheumatic disease","volume":"64","author":"Mandell","year":"2011","journal-title":"Rev. De Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.rmed.2006.04.028","article-title":"Isolated pleural and pericardial effusion in a patient with ankylosing spondylitis","volume":"101","author":"Erkan","year":"2007","journal-title":"Respir. Med."},{"key":"ref_41","first-page":"546","article-title":"Cardiovascular manifestations in ankylosing spondylitis. Concerning 210 cases","volume":"86","author":"Kaffel","year":"2008","journal-title":"La Tunisiemedicale"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.amjmed.2008.06.010","article-title":"Subclinical atherosclerosis in rheumatoid arthritis and systemic lupus erythematosus","volume":"121","author":"Salmon","year":"2008","journal-title":"Am. J. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"249","DOI":"10.7326\/0003-4819-144-4-200602210-00006","article-title":"Preclinical carotid atherosclerosis in patients with rheumatoid arthritis","volume":"144","author":"Roman","year":"2006","journal-title":"Ann. Intern. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.rdc.2010.02.002","article-title":"Cardiovascular complications of rheumatoid arthritis: Assessment, prevention, and treatment","volume":"36","author":"Kaplan","year":"2010","journal-title":"Rheum. Dis. Clin. North Am."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1177\/1759720X11436239","article-title":"Protective effect of methotrexate in patients with rheumatoid arthritis and cardiovascular comorbidity","volume":"4","author":"Marks","year":"2012","journal-title":"Ther. Adv. Musculoskelet. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"381931","DOI":"10.1155\/2015\/381931","article-title":"Asymptomatic atherosclerosis in Egyptian rheumatoid arthritis patients and its relation to disease activity","volume":"2015","author":"Elshereef","year":"2015","journal-title":"Int. J. Rheumatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.semarthrit.2008.02.001","article-title":"Endothelial dysfunction, carotid intima-media thickness, and accelerated atherosclerosis in rheumatoid arthritis","volume":"38","author":"Martin","year":"2008","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.3389\/fimmu.2017.01058","article-title":"Inflammatory Markers for Arterial Stiffness in Cardiovascular Diseases","volume":"8","author":"Mozos","year":"2017","journal-title":"Front. Immunol."},{"key":"ref_49","first-page":"8784971","article-title":"Crosstalk between Vitamins A, B12, D, K, C, and E Status and Arterial Stiffness","volume":"2017","author":"Mozos","year":"2017","journal-title":"Dis. Mark."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/01.md.0000101572.76273.60","article-title":"Increased prevalence of severe subclinical atherosclerotic findings in long-term treated rheumatoid arthritis patients without clinically evident atherosclerotic disease","volume":"82","author":"Llorca","year":"2003","journal-title":"Medicine (Baltim.)"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1161\/01.HYP.0000168055.89955.db","article-title":"Arterial stiffness in chronic inflammatory diseases","volume":"46","author":"Roman","year":"2005","journal-title":"Hypertension"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.3899\/jrheum.081253","article-title":"Metabolic syndrome is associated with increased arterial stiffness and biomarkers of subclinical atherosclerosis in patients with systemic lupus erythematosus","volume":"36","author":"Sabio","year":"2009","journal-title":"J. Rheumatol."},{"key":"ref_53","first-page":"8","article-title":"Cardiovascular disease in systemic sclerosis","volume":"3","author":"Cannarile","year":"2015","journal-title":"Ann. Transl. Med."},{"key":"ref_54","first-page":"51","article-title":"Risk of coronary artery disease in patients with ankylosing spondylitis: A systematic review and meta-analysis","volume":"3","author":"Ungprasert","year":"2015","journal-title":"Ann. Transl. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"342","DOI":"10.2310\/6670.2009.00023","article-title":"Cardiovascular involvement of ankylosing spondylitis: Report of three cases","volume":"17","author":"Yuan","year":"2009","journal-title":"Vascular"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/j.amjmed.2015.04.032","article-title":"Aortic Regurgitation Is Common in Ankylosing Spondylitis: Time for Routine Echocardiography Evaluation?","volume":"128","author":"Klingberg","year":"2015","journal-title":"Am. J. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1093\/eurheartj\/ehu107","article-title":"The ACC\/AHA 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: The good the bad and the uncertain: A comparison with ESC\/EAS guidelines for the management of dyslipidaemias 2011","volume":"35","author":"Ray","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1136\/annrheumdis-2016-209775","article-title":"EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015\/2016 update","volume":"76","author":"Agca","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1136\/annrheumdis-2013-203688","article-title":"Cardiovascular risk stratification in rheumatic diseases: Carotid ultrasound is more sensitive than Coronary Artery Calcification Score to detect subclinical atherosclerosis in patients with rheumatoid arthritis","volume":"72","author":"Corrales","year":"2013","journal-title":"Ann. Rheum Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1136\/annrheumdis-2012-203101","article-title":"Carotid ultrasound is useful for the cardiovascular risk stratification of patients with rheumatoid arthritis: Results of a population-based study","volume":"73","author":"Corrales","year":"2014","journal-title":"Ann. Rheum Dis."},{"key":"ref_61","first-page":"73","article-title":"Cardiovascular risk stratification in axial spondyloarthritis: Carotid ultrasound is more sensitive than coronary artery calcification score to detect high-cardiovascular risk axial spondyloarthritis patients","volume":"36","author":"Llorca","year":"2018","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1093\/eurheartj\/ehw106","article-title":"2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR)","volume":"37","author":"Piepoli","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1136\/annrheumdis-2019-215089","article-title":"2019 update of the EULAR recommendations for the management of systemic lupus erythematosus","volume":"78","author":"Fanouriakis","year":"2019","journal-title":"Ann. Rheum. Dis."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Ikonomidis, I., Makavos, G., Katsimbri, P., Boumpas, D.T., Parissis, J., and Iliodromitis, E. (2019). Imaging Risk in Multisystem Inflammatory Diseases. Jacc. Cardiovasc. Imaging.","DOI":"10.1016\/j.jcmg.2018.06.033"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1160\/TH11-02-0117","article-title":"Association of soluble apoptotic markers with impaired left ventricular deformation in patients with rheumatoid arthritis. Effects of inhibition of interleukin-1 activity by anakinra","volume":"106","author":"Ikonomidis","year":"2011","journal-title":"Thromb. Haemost."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1136\/hrt.2009.168971","article-title":"Lowering interleukin-1 activity with anakinra improves myocardial deformation in rheumatoid arthritis","volume":"95","author":"Ikonomidis","year":"2009","journal-title":"Heart"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"2662","DOI":"10.1161\/CIRCULATIONAHA.107.731877","article-title":"Inhibition of interleukin-1 by anakinra improves vascular and left ventricular function in patients with rheumatoid arthritis","volume":"117","author":"Ikonomidis","year":"2008","journal-title":"Circulation"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1161\/CIRCIMAGING.113.001193","article-title":"Increased benefit of interleukin-1 inhibition on vascular function, myocardial deformation, and twisting in patients with coronary artery disease and coexisting rheumatoid arthritis","volume":"7","author":"Ikonomidis","year":"2014","journal-title":"Circ. Cardiovasc. Imaging"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/6\/249\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:56:35Z","timestamp":1760187395000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/6\/249"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,6]]},"references-count":68,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,6]]}},"alternative-id":["medicina55060249"],"URL":"https:\/\/doi.org\/10.3390\/medicina55060249","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,6]]}}}