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Cardiac performance in collagen diseases estimated by non-invasive methods
M E Mavrikakis1, D Sideris, D Kontoyannis
1Department of Clinical Therapeutics, Alexandra Hospital, Athens Medical School, Greece.
Insights
Systemic lupus erythematosus (SLE) may enhance cardiac performance, indicated by altered systolic time intervals and higher ejection fraction (EF) in patients. These changes occur before direct heart involvement, suggesting a unique cardiovascular response in SLE.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Collagen diseases like rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and progressive systemic sclerosis (PSS) can affect myocardial performance.
- Assessing cardiac function early in these conditions is crucial for understanding disease impact.
Purpose of the Study:
- To investigate myocardial performance in patients with RA, SLE, and PSS.
- To compare cardiac function parameters, including systolic time intervals and ejection fraction (EF), with normal controls.
Main Methods:
- Systolic time intervals were measured using the first derivative of the carotid pulse in 16 SLE, 12 RA, and 11 PSS patients.
- Ejection fraction (EF) was evaluated using radionuclide left ventricular angiography in 33 patients.
- Data were compared against 103 normal persons for systolic time intervals and 22 normal controls for EF.
Main Results:
- Patients with SLE exhibited a significantly shorter pre-ejection period and longer ejection period.
- The ejection fraction (EF) was significantly higher in the SLE group compared to controls.
- Findings in the RA group generally showed opposite trends to those observed in SLE.
- These cardiac performance alterations in SLE were independent of age, blood pressure, disease duration, risk factors, or blood values.
Conclusions:
- Systemic lupus erythematosus (SLE) is associated with enhanced cardiac performance, characterized by specific systolic time interval changes and elevated ejection fraction (EF).
- These cardiovascular findings in SLE appear prior to direct cardiac involvement, indicating a distinct physiological response.
- The study highlights potential subclinical myocardial adaptations in SLE patients.
Abstract:
The myocardial performance was studied in 3 collagen diseases, i.e. rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and progressive systemic sclerosis (PSS). Sixteen patients with SLE, 12 with RA and 11 with PSS were examined, measuring the systolic time intervals from the first derivative of the carotid pulse in all cases. The ejection fraction (EF), was evaluated in 33 patients using radionuclide left ventricular angiography. The systolic time intervals were compared to those of 103 normal persons and the EF to that of 22 normal controls. In the SLE group the pre-ejection period was significantly shorter, while the ejection period was longer than normally expected. In the same group, the EF was significantly higher that the EF of the control group. These differences could not be related to age, blood pressure, disease duration, coronary risk factors, heart rate or blood values. Most findings in the RA group tended to be opposite to those of SLE. It is concluded that in SLE before any direct involvement of the heart the systolic time intervals and the EF present features similar to those of increased cardiac performance.