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Cardiac abnormalities in systemic lupus erythematosus: a prospective M-mode, cross-sectional and Doppler
Insights
Systemic lupus erythematosus (SLE) patients show a high rate of cardiac abnormalities, particularly pericardial and valve issues, detected via echocardiography. Routine cardiac screening is recommended for early detection and management of these lupus-related heart conditions.
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with potential multi-organ involvement.
- Cardiac manifestations are common in SLE but often subclinical.
- Echocardiography is a non-invasive tool for assessing cardiac structure and function.
Purpose of the Study:
- To evaluate the prevalence of cardiac abnormalities in patients with SLE using echocardiography.
- To correlate echocardiographic findings with clinical parameters in SLE patients.
- To determine the utility of echocardiography in routine cardiac evaluation for SLE.
Main Methods:
- Prospective study involving M-mode, cross-sectional, and Doppler echocardiography.
- 75 patients with SLE and 60 age- and sex-matched healthy controls were included.
- Clinical parameters were correlated with echocardiographic findings.
Main Results:
- Patients with SLE exhibited a higher prevalence of echocardiographic abnormalities compared to controls.
- Common findings included pericardial effusion/thickening (37%), mitral regurgitation (25%), and focal valvar thickening (12%).
- Pericardial effusion correlated with pericardial pain and active disease; left ventricular hypertrophy correlated with hypertension.
Conclusions:
- There is a high prevalence of cardiac abnormalities, especially pericardial and valvar lesions, in SLE patients.
- Echocardiography is crucial for identifying these cardiac manifestations in SLE.
- Routine echocardiographic screening is recommended for comprehensive cardiac evaluation in SLE patients.
Abstract:
A prospective M-mode, cross-sectional and Doppler echocardiographic study was performed on 75 patients with systemic lupus erythematosus and 60 sex- and age-matched control subjects. Compared with the control group, patients with lupus had an increased prevalence of echocardiographic abnormalities. These included pericardial effusion and/or thickening (37%), left ventricular hypertrophy (12%), global left ventricular hypokinesis (5%), segmental abnormalities of left ventricular wall motion (4%), right ventricular enlargement (4%), focal verrucous valvar thickening (12%), gross valvar thickening and dysfunction (8%), mitral regurgitation (25%) and aortic regurgitation (8%). Two patients with gross mitral valvar thickening and dysfunction subsequently underwent valvar replacement. Correlation between echocardiographic abnormalities and clinical parameters showed that pericardial effusion was significantly associated with pericardial pain (P less than 0.05) and active disease (P less than 0.001), and left ventricular hypertrophy with systemic hypertension (P less than 0.05). Thus, there was a high prevalence of cardiac abnormalities, especially pericardial and valvar lesions, in patients with systemic lupus erythematosus. Echocardiography is invaluable in identifying these abnormalities and should be used routinely for cardiac evaluation of these patients.