[Cardiac involvement in systemic autoimmune disease]

Pol Arch Med Wewn. 2003 Apr;109(4):375-81.
[Article in Polish]

Abstract

Systemic autoimmune diseases form a diverse group which includes: systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD), scleroderma, dermato-polymyositis, Wegener's granulomatosis, Sjögren syndrome. Although multisystem involvement is the hallmark of these diseases, the heart seems to be less affected than other organ systems. The aim of the study was to study possible cardiac abnormalities in patients with documented systemic autoimmune diseases and to assess whether there was any relation between antiphospholipid, anti-dsDNA antibodies and myocardial dysfunction findings. 76 patients (53 with SLE, 9 with MCTD, 8 with scleroderma, 6 with Wegener's granulomatosis) were subjected to our study, 69% of these patients manifested cardiac involvement, based on two-dimentional echocardiografic examination (36%--post-inflammatory valvular thickening, 20%--pericardial effusions, 15%--valvular regurgitation, 7%--left atrial enlargement, 5%--left ventricular hypertrophy, 4%--left ventricular dysfunction). None of the patients showed characteristic, acute Libman-Sacks endocarditis, which probably can be explained by chronic corticosteroid-treatment. Clinical evidence of cardiac abnormalities has been observed, in as many as 58% of cases with positive echocardiographic findings. The frequency and extend of cardiac pathology positively correlated with the detection of antiphospholipid antibodies. No such relationship was observed in patients with the presence of very high titers of antinuclear antibodies (anti-dsDNA). In conclusion, our results indicate that echocardiography is a useful method for assessment and monitoring cardiac involvement in the systemic autoimmune diseases.

Publication types

  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Antinuclear / immunology
  • Antibodies, Antiphospholipid / immunology
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / epidemiology*
  • Autoimmune Diseases / immunology
  • Coronary Disease / diagnosis
  • Coronary Disease / epidemiology*
  • Dermatomyositis / drug therapy
  • Dermatomyositis / epidemiology
  • Dermatomyositis / immunology
  • Electrocardiography
  • Female
  • Granulomatosis with Polyangiitis / drug therapy
  • Granulomatosis with Polyangiitis / epidemiology
  • Granulomatosis with Polyangiitis / immunology
  • Humans
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / epidemiology
  • Lupus Erythematosus, Systemic / immunology
  • Male
  • Middle Aged
  • Mixed Connective Tissue Disease / drug therapy
  • Mixed Connective Tissue Disease / epidemiology
  • Mixed Connective Tissue Disease / immunology
  • Scleroderma, Systemic / drug therapy
  • Scleroderma, Systemic / epidemiology
  • Scleroderma, Systemic / immunology
  • Sjogren's Syndrome / drug therapy
  • Sjogren's Syndrome / epidemiology
  • Sjogren's Syndrome / immunology

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Antinuclear
  • Antibodies, Antiphospholipid