Gentile R, Laganà B, Tubani L, Casato M, Ferri G M, Fedele F
Department of Clinical Medicine, La Sapienza University of Rome, Italy.
Ital Heart J. 2000 Jul;1(7):487-92.
The aim of this study was to evaluate the incidence of morphologic and functional cardiac abnormalities in patients with systemic lupus erythematosus and correlate the data with antiphospholipid antibody (aPL) levels.
Ninety-one patients with systemic lupus erythematosus were enrolled and divided into two groups according to the presence (Group 1, n = 45) or absence of aPL (Group 2, n = 46). All patients underwent standard two-dimensional and Doppler echocardiographic examination. aPL were detected by a standardized and validated ELISA test. Five patients with regional ventricular dysfunction also underwent coronary angiography. The chi2 test was used for the statistical analysis of the data. For smaller groups of samples the Fisher's exact test was employed.
Pericardial effusion was detected in 19 patients without any statistical difference between the two groups. A valvular involvement was present in 39 patients: a moderate-severe degree was more frequent in Group 1 (p = 0.02). Regional wall motion abnormalities were observed in 8 patients: only 1 in Group 2 and 7 in Group 1 (p = 0.03). Coronary angiography showed normal arteries in all patients of Group 1.
aPL play a role in the pathogenesis of the severity of valvular lesions as well as in regional myocardial dysfunction, suggesting a small vessel disease.
本研究旨在评估系统性红斑狼疮患者心脏形态和功能异常的发生率，并将数据与抗磷脂抗体（aPL）水平相关联。
纳入91例系统性红斑狼疮患者，根据是否存在aPL分为两组（第1组，n = 45；第2组，n = 46）。所有患者均接受标准二维和多普勒超声心动图检查。aPL通过标准化且经过验证的ELISA试验检测。5例有局部心室功能障碍的患者还接受了冠状动脉造影。数据采用chi2检验进行统计分析。对于较小样本组，采用Fisher精确检验。
19例患者检测到心包积液，两组之间无统计学差异。39例患者存在瓣膜受累：第1组中重度受累更为常见（p = 0.02）。8例患者观察到局部室壁运动异常：第2组仅1例，第1组7例（p = 0.03）。冠状动脉造影显示第1组所有患者动脉正常。
aPL在瓣膜病变严重程度的发病机制以及局部心肌功能障碍中起作用，提示存在小血管疾病。
