title: Cardiac dysfunction in patients with systemic lupus erythematosus and antiphospholipid syndrome.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Rheumatology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel. Parand@netvision.net.il
authors.forename: Daphna
authors.initials: D
authors.lastname: Paran
authors.forename: Dan
authors.initials: D
authors.lastname: Caspi
authors.forename: David
authors.initials: D
authors.lastname: Levartovsky
authors.forename: Ori
authors.initials: O
authors.lastname: Elkayam
authors.forename: Ilana
authors.initials: I
authors.lastname: Kaufman
authors.forename: Irena
authors.initials: I
authors.lastname: Litinsky
authors.forename: Gad
authors.initials: G
authors.lastname: Keren
authors.forename: Bella
authors.initials: B
authors.lastname: Koifman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016736:Antiphospholipid Syndrome / Q000150:complications*; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D018754:Ventricular Dysfunction / Q000000981:diagnostic imaging / Q000209:etiology*