title: Evaluation of early cardiac dysfunction in patients with systemic lupus erythematosus with or without anticardiolipin antibodies.
abstract: The aim of this study was to use transthoracic Doppler echocardiographic (TTE) imaging methods to identify cardiac dysfunction, an indicator of subclinical atherosclerosis in asymptomatic systemic lupus erythematosus (SLE) patients in terms of cardiac effects. This study involved 80 patients: a study group (n = 50) and control group (n = 30). They were categorized into four subgroups: anticardiolipin antibodies (aCL) (+) (n = 14) and aCL (-) (n = 36); systemic lupus erythematosus disease activity index (SLEDAI) ≥ 6 (n = 15) and SLEDAI < 6 (n = 35); disease period ≥ 5 years (n = 21) and disease period < 5 years (n = 29); major organ involvement (+) (n = 19), major organ involvement (-) (n = 31). The ratio of mitral peak velocity of early filling to early diastolic mitral annular velocity (E/E') for the study group was found to be higher than the control (p < 0.01). Systolic septal motion velocity (Ssm) was lower in the study group compared with the control (p < 0.01). Left atrium (LA) dimension was greater in the study group than the control (p < 0.01). Ssm was found to be lower in the aCL (+) patients compared with the control and aCL (-) groups (p < 0.01, p < 0.05, respectively). LA dimension was greater in the aCL (+) and (-) groups compared with the control, (p < 0.01, p < 0.05, respectively) and aCL groups compared with each other (p < 0.05). The E/E' ratio for the aCL (+) and (-) groups was found to be greater than the control (p < 0.05). In the study, both the Ssm and the late diastolic septal velocity (sA') was found to be lower in the SLEDAI ≥ 6 group compared with SLEDAI<6 group, (p < 0.001, p < 0.05, respectively). LA dimension was statistically greater in the SLEDAI ≥ 6 group compared with the SLEDAI <6 group (p < 0.001). E' and early diastolic septal velocity (sE') were statistically lower in the disease period >5 years group compared with the disease period <5 years group (p < 0.01, p < 0.05, respectively). Carrying out regular scans with TTE image of SLE patients is important in order to identify early cardiac involvement during monitoring and treatment. Identifying early cardiac involvement in SLE may lead to a reduction in mortality and morbidity rates.
authors.affiliation: Department of Cardiology, Faculty of Medicine, çanakkale Onsekiz Mart University, çanakkale, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Barutcu
authors.affiliation: Istanbul Medeniyet University , Cardiology Goztepe Training and Research Hospital, Istanbul, Turkey feyzaulusoyaksu@yahoo.com.
authors.forename: F
authors.initials: F
authors.lastname: Aksu
authors.affiliation: Department of Cardiology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Ozcelik
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors.forename: C A E
authors.initials: CA
authors.lastname: Barutcu
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors.forename: G E
authors.initials: GE
authors.lastname: Umit
authors.affiliation: Department of Rheumatology, Faculty ofMedicine, Trakya University, Edirne, Turkey.
authors.forename: O N
authors.initials: ON
authors.lastname: Pamuk
authors.affiliation: Department of Cardiology, Faculty of Medicine, Baskent University, Istanbul Hospital, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Altun
mesh_terms: D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000276:immunology*; D050197:Atherosclerosis / Q000000981:diagnostic imaging; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000276:immunology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging* / Q000276:immunology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000502:physiology; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000276:immunology
chemical_list: D017153:Antibodies, Anticardiolipin
keywords: Anticardiolipin antibody; cardiovascular disease; diastolic dysfunction; systemic lupus erythematosus; tissue Doppler