scholarly journals Cardiovascular Involvement in Systemic Lupus Erythematosus

Author(s):  
Sultana Abdulaziz ◽  
Yahya AlGhamdi ◽  
Mohammed Samannodi ◽  
Mohammed Shabrawishi
2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Niari ◽  
M R Jena ◽  
M Parida ◽  
S R Tripathy ◽  
R Tripathy ◽  
...  

Abstract Introduction The cardiovascular system is affected in systemic lupus erythematosus (SLE) by the disease itself, the state of chronic inflammation and also by the side effects of the treatment given. Purpose To find the burden of cardiovascular involvement in SLE, to correlate cardiovascular manifestation with SLE disease activity (SLEDAI-2K) and damage [SLICC/ACR Damage Index (SDI)]. Methods Seventy-five consecutive SLE patients fulfilling SLICC criteria, aged between 15–55 years, with disease duration of <5 years, admitted to rheumatology ward, were included. Overlap syndromes, past history of cardiac disease, end stage renal disease, chronic liver disease and type 2 diabetes mellitus were excluded. Clinical examination, fasting serum lipid profile, electrocardiogram, 2D-Echocardiography, carotid intima media thickness (CIMT) and serum Troponin-I were used to assess the cardiovascular status of patients. Results In this cross-sectional study exploring cardiovascular disease burden in a cohort of SLE patients within 5 years of disease, we found the mean age of patients was 28.5±7.9 years with a male: female ratio of 1:14. Cardiovascular involvement was detected in 52% of patients. Raised systolic BP was detected in 42% and raised diastolic BP in 28% patients. ECG revealed sinus tachycardia in 32%. 2D-echocardiography revealed pericardial effusion in 14.66%, mitral valve involvement in 10.66% (7 had mitral regurgitation and one had mitral sclerosis). PAH and TR were observed in 5.33% and 6.66% of cases respectively. One case showed evidence of aortic sclerosis. Dilated cardiomyopathy was present in 2.66% of cases. In 2.66% of cases systolic dysfunction and diastolic dysfunction each was evident. No patient showed evidence of vegetations. Anti SS-A and anti nucleosome (30.7% each) were the most common antibodies found in SLE patients with cardiovascular involvement. Increased serum LDL, hypertriglyceridemia and low serum HDL was found in 29%, 47% and 51% of patients respectively. Sub clinical myocardial injury was absent in all our patients as evidenced by negative serum Troponin-I. The CIMT was within normal limits and comparable between patients with and without cardiovascular involvement. The mean SLEDAI-2K was 7.3±4.9 and mean SDI was 0.8±1.2. SLEDAI-2K and SDI were significantly higher in patients with cardiovascular involvement versus patients without cardiovascular involvement (p=0.002 and p=0.01 respectively). SLEDAI-2K and SDI vs cardiac involvement Conclusion Cardiovascular involvement is associated with high SLEDAI-2K and SDI. Presence of anti-SSA and anti-nucleosome antibodies may predispose to cardiovascular involvement. Pericardial effusion was the most common echocardiographic abnormality. Low HDL was the most common dyslipidemia. However,atherosclerosis is not evident in patients with SLE with disease duration less than 5 years.


2009 ◽  
Vol 37 (1) ◽  
pp. 79-86 ◽  
Author(s):  
SEBASTIAN J. BUSS ◽  
DAVID WOLF ◽  
GRIGORIOS KOROSOGLOU ◽  
REGINA MAX ◽  
CELINE S. WEISS ◽  
...  

Objective.Systemic lupus erythematosus (SLE) is associated with high cardiovascular morbidity and mortality. Cardiovascular involvement is frequently underestimated by routine imaging techniques. Our aim was to determine if new echocardiographic imaging modalities like tissue Doppler (TDI), strain rate (SRR), and strain (SRI) imaging detect abnormalities in left ventricular (LV) function in asymptomatic patients with SLE.Methods.Sixty-seven young patients with SLE (mean age 42 ± 10 yrs) without typical symptoms or signs of heart failure or angina, and a matched healthy control group (n = 40), underwent standard transthoracic echocardiography, TDI, SRR, and SRI imaging of the LV as well as assessment of disease characteristics.Results.Despite findings within the normal range on routine standard 2-dimensional echocardiography, SLE was associated with significantly impaired systolic and diastolic myocardial velocities of the LV measured by TDI [mean global TDI: systolic (s): 2.9 ± 0.9 vs 3.9 ± 0.7 cm/s, p < 0.05; early (e): 4.3 ± 1.5 vs 6.3 ± 1.3 cm/s, p < 0.05; late (a): 2.9 ± 0.8 vs 3.4 ± 0.8 cm/s, p < 0.05; values ± SD); SRR (s: −0.8 ± 0.1 vs −1.1 ± 0.1 s−1; e: 1.1 ± 0.2 vs 1.6 ± 0.3 s−1; a: 0.7 ± 0.1 vs 1.0 ± 0.2 s−1; all p < 0.05); and SR (−15.11 ± 2.2% vs −19.7 ± 1.9%; p < 0.05) compared to the control group. Further, elevated disease activity, measured with the ECLAM and the SLEDAI score, resulted in significantly lower values for LV longitudinal function measured by SRR and SR, but not by TDI.Conclusion.SLE is associated with a significant impairment of systolic and diastolic LV longitudinal function in patients without cardiac symptoms. New imaging modalities provide earlier insight into cardiovascular involvement in SLE and seem to be superior to standard echocardiography to detect subclinical myocardial disease.


2017 ◽  
Vol 9 (1) ◽  
pp. 75
Author(s):  
M. Kechida ◽  
R. Klii ◽  
S. Arfa ◽  
W. Jomaa ◽  
K. Ben Hamda ◽  
...  

Author(s):  
Francis R. Comerford ◽  
Alan S. Cohen

Mice of the inbred NZB strain develop a spontaneous disease characterized by autoimmune hemolytic anemia, positive lupus erythematosus cell tests and antinuclear antibodies and nephritis. This disease is analogous to human systemic lupus erythematosus. In ultrastructural studies of the glomerular lesion in NZB mice, intraglomerular dense deposits in mesangial, subepithelial and subendothelial locations were described. In common with the findings in many examples of human and experimental nephritis, including many cases of human lupus nephritis, these deposits were amorphous or slightly granular in appearance with no definable substructure.We have recently observed structured deposits in the glomeruli of NZB mice. They were uncommon and were found in older animals with severe glomerular lesions by morphologic criteria. They were seen most commonly as extracellular elements in subendothelial and mesangial regions. The deposits ranged up to 3 microns in greatest dimension and were often adjacent to deposits of lipid-like round particles of 30 to 250 millimicrons in diameter and with amorphous dense deposits.


2000 ◽  
Vol 6 (7) ◽  
pp. 821-825 ◽  
Author(s):  
ELIZABETH LERITZ ◽  
JASON BRANDT ◽  
MELISSA MINOR ◽  
FRANCES REIS-JENSEN ◽  
MICHELLE PETRI

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