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Cardiac dysfunction in SLE and antiphospholipid syndrome patients
  1. Daphna Paran (parand{at}netvision.net.il)
  1. Dept of Rheumatology, Tel-Aviv Sourasky Medical Center, Israel
    1. Dan Caspi
    1. Dept of Rheumatology, Tel-Aviv Sourasky Medical Center, Israel
      1. David Levartovsky
      1. Dept of Rheumatology, Tel-Aviv Sourasky Medical Center, Israel
        1. Ori Elkayam
        1. Dept of Rheumatology, Tel-Aviv Sourasky Medical Center, Israel
          1. Ilana Kaufman
          1. Dept of Rheumatology, Tel-Aviv Sourasky Medical Center, Israel
            1. Irena Litinsky
            1. Dept of Rheumatology, Tel-Aviv Sourasky Medical Center, Israel
              1. Gad Keren
              1. Dept of Cardiology, Tel-Aviv Sourasky Medical Center, Israel
                1. Bella Koifman
                1. Dept of Cardiology, Tel-Aviv Sourasky Medical Center, Israel

                  Abstract

                  Objective: To comparatively assess parameters of systolic and diastolic cardiac function in SLE and antiphospholipid syndrome (APS) patients.

                  Methods: Consecutive patients (N=74) who were free of cardiovascular symptoms were divided into 4 groups: 1) SLE (N=23); 2) SLE with antiphospholipid antibodies (aPL) (N=18); 3) SLE with APS (N=20); 4) Primary antiphospholipid syndrome (PAPS) (N=13). Pulsed, continuous, color Doppler echocardiography, and M- and B- mode studies were performed.

                  Results: Left ventricular (LV) end diastolic and end systolic dimensions were higher in SLE as compared to PAPS patients (p=0.022; p=0.022, respectively), with a trend toward a lower fractional shortening in SLE (p=0.07), suggesting systolic dysfunction. Parameters of diastolic function were more impaired in APS patients, reflected by lower LV and right ventricular (RV) E/A ratios in APS (groups 3, 4) compared to non-APS patients (groups 1, 2) (1.15+0.40 vs.1.49+0.43, p=0.001 and 1.19+0.31 vs. 1.49+0.41, p=0.001, respectively) and a more prolonged LV isovolumic relaxation time (LVIVRT) (94.2 +24.6 ms vs. 84.4+17.0 ms respectively, p=0.055). APS patients were older than non-APS (47.12+14.86 vs. 34.29+12.6, p=0.0001). SLE patients were younger than PAPS (38.19+14.68 vs. 48.53+13.97, p=0.023).

                  Conclusion: Abnormal echocardiographic findings were detected frequently in asymptomatic patients with SLE or PAPS. Although SLE patients were younger, LV systolic function was more impaired in SLE compared to PAPS patients while LV and RV diastolic function, as reflected by LVIVRT and E/A ratios, were significantly more impaired in APS patients.

                  • antiphospholipid syndrome
                  • echocardiography
                  • systemic lupus erythematosus

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