[Cardiovascular monitoring of patients with systemic lupus erythematosus].
Accelerated atherosclerotic cardiovascular disease is increasingly recognized as a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Cardiac manifestations of SLE are frequent and can involve almost all components of the heart. Pulmonary hypertension often develops during the course of SLE. The high incidence of cardiovascular complications may justify a screening of SLE patients in order to ensure early diagnosis and therapy. Results of diagnostic procedures that detect coronary insufficiency, surrogates of atherosclerotic burden and echocardiographic findings are often abnormal in SLE. However, evidence to support a routine screening for cardiovascular disease is currently not available. Therefore, based on the recommendations that have been proposed for other conditions associated with cardiovascular disease, we suggest assessment of risk factors and the performance of echocardiography at least annually in asymptomatic SLE patients. If two or more risk factors are present, an exercise ECG is recommended. The benefit, however, of screening SLE patients for cardiovascular disease has to be confirmed in prospective studies.
Schotte
H
H
Medizinische Klinik und Poliklinik B, Universitätsklinikum Münster, Albert-Schweitzer-Str. 33, 48129 Münster, Germany. h.schotte@uni-muenster.de
Becker
H
H
Domschke
W
W
Gaubitz
M
M
D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology*; D002986:Clinical Trials as Topic; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000209:etiology*; D008403:Mass Screening / Q000379:methods; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014463:Ultrasonography