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[Abnormal findings of cardiac function in patients with systemic lupus erythematosus (author's transl)]
Insights
Systemic lupus erythematosus (SLE) significantly impacts cardiac function, with most patients experiencing reduced cardiac capacity. About 20% face severe cardiac issues, necessitating medical intervention.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Context:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
- Cardiac involvement is a significant but often underdiagnosed complication in SLE patients.
- Assessing cardiac function is crucial for managing SLE and preventing long-term sequelae.
Purpose:
- To determine the prevalence and severity of cardiac involvement in patients with SLE.
- To evaluate cardiac function using various diagnostic tools, including echocardiography and right heart catheterization.
- To identify specific echocardiographic and hemodynamic abnormalities associated with SLE.
Summary:
- Echocardiography revealed abnormalities in 62% of SLE patients, including interventricular septum thickening (31%) and right ventricular enlargement (23%).
- Right heart catheterization in 23 SLE patients showed elevated mean pulmonary artery pressure in 19, with 5 exceeding 40 mm Hg.
- Exercise intolerance was common, with most patients experiencing muscular insufficiency or dyspnea, and only 4 reaching 90% of maximal heart rate.
Impact:
- Approximately 80% of SLE patients exhibit reduced cardiac capacity, with 20% experiencing severe impairment.
- These findings highlight the high incidence of cardiac dysfunction in SLE and the need for proactive cardiac monitoring.
- The study underscores the necessity of discussing medical treatment for cardiac complications in SLE patients.
Abstract:
To find out the rate of cardiac involvement among patients with systemic lupus erythematosus (SLE), 34 patients with SLE were examined by ECG, x-ray of the chest, body plethysmography, one- and two-dimensional echocardiography In addition, in 23 patients with SLE a microcatheterization of the right heart side was undertaken with measuring of the mean pulmonary artery pressure and cardiac index during exercise. Echocardiography revealed moderate abnormal findings in 62% of the patients. In particular, there was a thickening of the interventricular septum (31%), an enlargement of the right ventricle (23%), a diminution of the left ventricular fractional shortening (16%), an augmentation of the left atrium (10%) and of the left ventricle (6%). A small pericardial effusion was observed in 6% and a thickening of the left ventricular posterior wall in 3%. At micro-catheterization in 19 out of 23 patients with SLE, there was an increase of the mean pulmonary artery pressure up to abnormal values. In 5 patients, mean pulmonary pressure rose over 40 mm Hg. Most of the patients also showed an increase of the arterial pressure up to pathological values. Furthermore, most of the patients finished exercise because of muscular insufficiency or dyspnoea. Only 4 of 23 patients with SLE reached 90% of the age-corresponding maximal heart rate. The results indicate that with about 80% of all patients with SLE the cardiac capacity is reduced. In about 20% of the patients with SLE, this diminution of cardiac capacity is severe, and the necessity of medical treatment has to be discussed.