Echocardiographic characteristics of cardiac involvement in Systemic lupus erythematosus

##plugins.themes.academic_pro.article.sidebar##

Published Jun 24, 2019
Download
pdf
Vol. 97 No. 2 (2019): Issue Feb 2019

##plugins.themes.academic_pro.article.main##

Meriem Drissa
Sana Helali
Farah Amani
Marwa Chebbi
Mehdi Mechri
Habiba Drissa

Abstract

Introduction :  Echocardiography is   a non invasive tool for the assessment of   systemic lupus erythematesus  (SLE)  involvement  .

Aim of study:  to investigate the cardiac involvement in patients diagnosed with SLE assessed  by echocardiography  and  to  study relationship between several factors and  cardiac manifestation .
Methods :   retrospective study  of 76 patients with diagnosis of SLE between   2008  and 2017.   All patients were asssesed by echocardiography  .Patients were  assigned  into cardiac abnormalities group    and non cardiac  abnormmalties  and  compared  to  study relations between several factors and  cardiac manifestation .
Result :Cardiac involvement was found in echocardiography in 52% of patients (40 patients.  
Echocardiographic findings showed  12 cases ( 38 %) of pericardial effusion . Valvular  abnormalities were observed in  19 cases (48 %),  Myocardium was involved in 5 cases ( 12.5 %). there were no cases  of myocarditis   , High arterial pulmonary hypertension was reported in  4  cases (10%).
Men   were  more vulnerable  to  cardiac involvement in lupus , there was signifiant relationship  between  disease  duration and cardiac abnormalities  (p 0.04 ), age  was not  associated  significantly to  echocardiographic  abnormalites ,positif antiphospholipid  antibodies(aPL+)  was   observed in  higher  frequency in   cardiac involvement  group with p<0.01 and especially in  valvular anomalies 

Conclusion : Echocardiography should be routinely indicated for evaluation of cardiac involvement during SLE. These manifestations   are most often moderate and asymptomatic. Pericardial effusion, and valvular involvement were the most frequent abnormalities.

Keywords:

systemic lupus erythematosus , echocardiography , cardiac involvement

##plugins.themes.academic_pro.article.details##

References

  1. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus Arthritis Rheum, 40 (1997).
  2. Kevin G. Moder, M.D, Todd D. Cardiac Involvement in Systemic Lupus Erythematosus. Mayo Clin Proc 1999;74:275-284
  3. Jain D, Halushka. M K. Cardiac pathology of systemic lupus erythematosus. Journal of Clinical Pathology 2009; 62(7):584-592.
  4. Dori A, Iaccarino, L Sarzi-Puttini P, et al. Cardiovascular involvement in systemic lupus erythemathosus. Lupus 200 vol. 1468 3-96
  5. Plazak W Gryga, Milewski M, Podolec M, Kostkiewicz M, Podolec P, et al. Association of heart structure and function abnormalities with laboratory findings in patients with systemic lupus erythematosus.Lupus 2011;20(9):936-44.
  6. Doria A, Iaccarino L, Sarzi-Puttini P ?, Atzeni F, Turriel M, Petri M. et al. Cardiovascular involvement in systemic lupus erythemathosus. Lupus 2005;14:683-6.
  7. Wijetunga M, Rockson S. Myocarditis in Systemic Lupus Erythematosus. Am J Med. 2002; 113:419- 423.
  8. Yu XH, Li YN. Echocardiographic abnormalities in a cohort of Chinese patients with systemic lupus erythematosus. A retrospective analysis of eighty-five cases. J Clin Ultrasound. 2011;39(9):519-26.
  9. JA Woodard, PK Davila-Roman VG, et al. Cardiac magnetic resonance imaging abnormalities in systemic lupus erythematosus: a preliminary report. Lupus. 2005;14(2):137-44.
  10. Buss SJ, Wolf D, Korosoglou G, Max R, Weiss CS, Fischer C, -Myocardial left ventricular dysfunction in patients with systemic lupus erythematosus: new insights from tissue Doppler and strain imaging.J Rheumatol. 2010 Jan;37(1):79-86.
  11. S. Zuily, V. Regnault, C. Selton-Suty V, Eschwège V, Bruntz JF, Bode-Dotto E, et al. Increased risk for heart valve disease associated with antiphospholipid antibodies in patients with systemic lupus erythematosus: meta-analysis of echocardiographic studies Circulation, 124 (2) (2011), pp. 215-224
  12. Sherson RA, Ames D, Coltart J, Byrne C, and Hughes GR. Hypertrophic cardiomyopathy in systemic lupus erythematosus and “lupus-like” disease: chance association? A report of 2 cases.J Rheumatol. 1992; 19: 1973-1979
  13. Moyssakis I, Tektonidou MG, Vasilliou VA,Samarkos M, Votteas V, Moutsopoulos HM. et al. Libman-Sacks endocarditis in systemic lupus erythematosus: prevalence, associations, and evolution. Am J Med 2007;120: 636-42
  14. Tselios K, Gladman D, and Urowitz M. Systemic lupus erythematosus and pulmonary arterial hypertension: links, risks, and management strategies. Open Access Rheumatol. 2017; 9: 1-9
  15. Foïs E , Le Guern V, Dupuy A, Humbert M, Mouthon L, Guillevin L, et al. Noninvasive assessment of systolic pulmonary artery pressure in systemic lupus erythematosus: retrospective analysis of 93 patients. Clin Exp Rheumatol. 2010;28 (6):836-41
  16. Shazzad MN, Islam MN, Ara R, Ahmed CM, Fatema N, Azad AK, et al .Echocardiographic assessment of cardiac involvement in systemic lupus erythematosus patients. Mymensingh Med J. 2013 Oct;22(4):736-41.
  17. T.M. Reshetniak, G.P. Kotel'nikova, O.A. Fomicheva, N.G. Kliukvina NG, Karpov IuA , Alexandrova EN , et al. Cardiological aspects of the antiphospholipid syndrome. Part I. Valvular lesions in the primary and secondary antiphospholipid syndrome and systemic lupus erythematosus Kardiologiia, 42 (8) (2002), pp. 38-43
  18. Soltész P, Szekanecz Z, KissY, Kliukvina NG, Karpov A, Alexandrova L et al. Cardiac manifestations in antiphospholipid syndrome Autoimmun Rev, 6 (6) (2007), pp. 379-386