[Assessment of myocardial perfusion in systemic lupus erythematosus].
BACKGROUND
Cardiovascular disease is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Necropsy studies found a high incidence of myocardial and coronary injuries while clinical manifestations were observed in less than 10%. The purpose of this study was to evaluate myocardial perfusion in SLE patients.


METHODS
The study was carried out in 153 patients with a definite diagnosis of SLE according to the revised criteria of the American College of Rheumatology. Ninety-four (61.4%) underwent 99mTc-tétrofosmine SPECT analysis at rest and after stress.


RESULTS
The average disease duration was 11 years. Ninety-four patients (93 women and one man) with a mean age 37 years were assessed. Twelve had a past history of vascular event: six stroke, four angina pectoris and two myocardial infarctions. Cardiovascular risk factor included: high blood pressure (35.2%), dyslipidemia (62.3%), moderate hyperhomocysteinemia (55%), BMI greater than 25 (40%).The cumulative prednisone dose per patient was 45.5g. Myocardial perfusion stress scanning showed abnormal perfusion in 21 patients (22.3%). Among these, eight underwent coronary angiography which was normal in seven cases. One patient had a right coronary stenosis. Perfusion abnormalities were correlated with stroke (p<0.01) and coronary events (p<0.02).


CONCLUSIONS
Myocardial perfusion scintigraphy can be a useful noninvasive method to identify subclinical myocardial involvement in systemic lupus erythematosus and patients at risk of later events.
Boucelma
M
M
Service de médecine interne, hôpital Mohamed-Lamine-Debaghine, CHU Bab-El-Oued, boulevard Said-Touati 16009, Alger, Algérie. mboucelma@yahoo.fr
Tahmi
M
M
Chaudet
H
H
Drahmoune
R
R
Bouyoucef
S E
SE
Hakem
D
D
Berrah
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin