Cujec B, Sibley J, Haga M
Department of Medicine, Royal University Hospital, Saskatoon, Saskatchewan.
Can J Cardiol. 1991 Oct;7(8):343-9.
To determine the prevalence of cardiac abnormalities in patients with systemic lupus erythematosus.
Prospective survey.
Rheumatic diseases unit of a university hospital.
Volunteer sample comprising 83% of patients with systemic lupus erythematosus followed annually in the rheumatic disease unit (93 patients; mean age 46 +/- 13 years; female 79, male 14). These patients were age-matched with 16 female control volunteers (mean age 43 +/- 5 years) recruited from hospital staff.
Electrocardiograms, two-dimensional echocardiograms and radionuclide angiograms were performed in patients and controls. Anticardiolipin antibodies were measured by enzyme-linked immunosorbent assay in the systemic lupus erythematosus patients.
At least one cardiac abnormality was detected in 44 of 93 systemic lupus erythematosus patients (47%). These abnormalities included: aortic valve thickening 12%; mitral valve thickening, prolapse, vegetations or stenosis 23%; left ventricular segmental dysfunction 4%; left ventricular global hypokinesis 4%; right ventricular hypokinesis 4%; left ventricular hypertrophy 14%; left ventricular diastolic dysfunction 16%; and pericardial effusion 2%. Three of the 16 controls (19%) had cardiac abnormalities consisting of mitral valve prolapse (one), right ventricular hypokinesis (one) and pericardial effusion (one). Cardiac abnormalities were more common in the systemic lupus erythematosus group compared with controls (47% versus 19%, P less than 0.05). Raised anticardiolipin antibodies were specific (88%) but not sensitive (33%) for the presence of cardiac abnormalities in systemic lupus erythematosus patients. Renal disease and prednisone therapy were more common in systemic lupus erythematosus patients with cardiac involvement than in such patients without evidence of cardiac disease (40% versus 16%, P = 0.03; and 81% versus 59%, P = 0.04, respectively).
Cardiac abnormalities can be identified noninvasively in 47% of patients with systemic lupus erythematosus.
确定系统性红斑狼疮患者心脏异常的患病率。
前瞻性调查。
一所大学医院的风湿病科。
志愿者样本，包括每年在风湿病科随访的83%的系统性红斑狼疮患者（93例；平均年龄46±13岁；女性79例，男性14例）。这些患者与从医院工作人员中招募的16名女性对照志愿者（平均年龄43±5岁）年龄匹配。
对患者和对照进行心电图、二维超声心动图和放射性核素血管造影检查。通过酶联免疫吸附测定法检测系统性红斑狼疮患者的抗心磷脂抗体。
93例系统性红斑狼疮患者中有44例（47%）检测到至少一项心脏异常。这些异常包括：主动脉瓣增厚12%；二尖瓣增厚、脱垂、赘生物或狭窄23%；左心室节段性功能障碍4%；左心室整体运动减弱4%；右心室运动减弱4%；左心室肥厚14%；左心室舒张功能障碍16%；心包积液2%。16名对照中有3例（19%）存在心脏异常，包括二尖瓣脱垂（1例）、右心室运动减弱（1例）和心包积液（1例）。与对照组相比，系统性红斑狼疮组心脏异常更为常见（47%对19%，P<0.05）。抗心磷脂抗体升高对系统性红斑狼疮患者心脏异常的存在具有特异性（88%）但不敏感（33%）。有心脏受累的系统性红斑狼疮患者中肾病和泼尼松治疗比无心脏疾病证据的此类患者更常见（分别为40%对16%，P = 0.03；81%对59%，P = 0.04）。
47%的系统性红斑狼疮患者可通过无创方法识别心脏异常。
