RT Journal Article
SR Electronic
T1 Cardiac dysfunction in patients with systemic lupus erythematosus and antiphospholipid syndrome
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 506
OP 510
DO 10.1136/ard.2005.044073
VO 66
IS 4
A1 Daphna Paran
A1 Dan Caspi
A1 David Levartovsky
A1 Ori Elkayam
A1 Ilana Kaufman
A1 Irena Litinsky
A1 Gad Keren
A1 Bella Koifman
YR 2007
UL http://ard.bmj.com/content/66/4/506.abstract
AB Objective: To comparatively assess the parameters of systolic and diastolic cardiac function in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). Methods: Consecutive patients (n = 74) who were free of cardiovascular symptoms were divided into four groups: (1) SLE (n = 23); (2) SLE with antiphospholipid antibodies (aPL; n = 18); (3) SLE with APS (n = 20); and (4) primary antiphospholipid syndrome (PAPS; n = 13). Pulsed, continuous, colour Doppler echocardiography, and M-mode and B-mode studies were performed. Results: Left ventricular end diastolic and end systolic dimensions were higher in SLE as compared with patients with PAPS (p = 0.022 and 0.022, respectively), with a trend towards a lower fractional shortening in SLE (p = 0.07), suggesting systolic dysfunction. Parameters of diastolic function were more impaired in patients with APS, reflected by lower left ventricular and right ventricular E wave to A wave (E:A) ratios in patients with APS (groups 3, 4) compared with those without APS (groups 1, 2; 1.15 (0.40) v 1.49 (0.43), p = 0.001 and 1.19 (0.31) v 1.49 (0.41), p = 0.001, respectively) and a more prolonged left ventricular isovolumic relaxation time (IVRT; 94.2 (24.6) v 84.4 (17) ms, respectively, p = 0.055). Patients with APS were older than those without APS (47.12 (14.86) v 34.29 (12.6), p = 0.0001). Patients with SLE were younger than those with PAPS (38.19 (14.68) v 48.53 (13.97), p = 0.023). Conclusion: Abnormal echocardiographic findings were detected frequently in asymptomatic patients with SLE or PAPS. Although patients with SLE were younger, left ventricular systolic function was more impaired in patients with SLE compared with those with PAPS, whereas left ventricular and right ventricular diastolic function, as reflected by IVRT and E:A ratios, were significantly more impaired in patients with APS.