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Pulmonary hypertension in systemic lupus erythematosus
J S Simonson1, N B Schiller, M Petri
1Department of Medicine, University of California School of Medicine, San Francisco.
The Journal of Rheumatology
|July 1, 1989
Summary
Pulmonary hypertension is common in patients with systemic lupus erythematosus (SLE), affecting 14% of those studied. While often mild, it is associated with shorter disease duration and specific treatments.
Area of Science:
- Cardiology
- Rheumatology
- Pulmonology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse organ involvement.
- Pulmonary hypertension (PH) is a potential complication of SLE, but its prevalence and characteristics require further elucidation.
Purpose of the Study:
- To determine the prevalence and severity of pulmonary hypertension in patients with SLE.
- To investigate potential associations between PH and clinical characteristics in SLE patients.
Main Methods:
- Prospective study involving 36 SLE patients and 26 healthy controls.
- Pulmonary artery systolic pressure (PASP) calculated using Doppler echocardiography and estimated right atrial pressure.
- Cardiac index assessed via 2D echocardiography.
Main Results:
- 14% of SLE patients (5/36) exhibited pulmonary hypertension (PASP > 30 mm Hg).
- Mean PASP was significantly higher in SLE patients (25 +/- 10 mm Hg) compared to controls (20 +/- 2 mm Hg; p = 0.002).
- Patients with PH had shorter SLE duration, less steroid use, and higher rates of cytotoxic treatment and Raynaud's phenomenon.
Conclusions:
- Pulmonary hypertension is a common finding in SLE, though typically mild.
- Increased pulmonary vascular resistance is the likely cause of elevated pulmonary artery pressure in these patients.
- Specific SLE treatment modalities and disease duration may influence PH development.