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Myocardial perfusion scintigraphy and coronary disease risk factors in systemic lupus erythematosus

E M C Sella1, E I Sato, W A Leite

  • 1Rheumatology Division, Universidade Federal de São Paulo, Escola Paulista de Medicina, Brazil.

Annals of the Rheumatic Diseases
|October 30, 2003
PubMed

Insights

Systemic lupus erythematosus (SLE) patients often have abnormal myocardial perfusion, linked to lower HDL cholesterol and diabetes. Current vasculitis also correlates with these perfusion defects, suggesting subclinical atherosclerosis in SLE.

Area of Science:

  • Cardiology
  • Rheumatology
  • Nuclear Medicine

Background:

  • Systemic lupus erythematosus (SLE) is an autoimmune disease associated with increased cardiovascular risk.
  • Subclinical atherosclerosis may be prevalent in SLE patients, even without typical cardiac symptoms.

Purpose of the Study:

  • To determine the prevalence of myocardial perfusion abnormalities in female SLE patients.
  • To investigate the association between these perfusion defects and traditional coronary artery disease (CAD) risk factors, as well as SLE-specific factors.

Main Methods:

  • Evaluated 82 female SLE patients (age 18-55, disease duration >5 years, steroid use >1 year).
  • Assessed traditional CAD risk factors (hypertension, diabetes, dyslipidemia, etc.).
  • Utilized technetium 99m-sestamibi myocardial perfusion scintigraphy (SPECT) at rest and during dipyridamole stress.

Main Results:

  • Myocardial perfusion abnormalities were detected in 28% of patients.
  • Lower high-density lipoprotein (HDL) cholesterol and diabetes mellitus were significantly associated with abnormal scintigraphy.
  • Current vasculitis also showed a significant association with abnormal myocardial perfusion.

Conclusions:

  • Lower HDL cholesterol and diabetes mellitus are key factors influencing abnormal myocardial perfusion in asymptomatic SLE patients.
  • Abnormal myocardial perfusion in SLE may indicate underlying subclinical atherosclerosis.
  • Current vasculitis is linked to abnormal myocardial perfusion in this cohort.
Abstract

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