The heart in systemic lupus erythematosus - A comprehensive approach by cardiovascular magnetic resonance tomography.
The heart in systemic lupus erythematosus - A comprehensive approach by cardiovascular magnetic resonance tomography.
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DOI：
10.1371/journal.pone.0202105
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Zellweger MJ
中科院分区：
文献类型：
--
作者：
Burkard T;Trendelenburg M;Daikeler T;Hess C;Bremerich J;Haaf P;Buser P;Zellweger MJ
在系统性红斑狼疮（SLE）中，心脏表现，例如冠状动脉疾病（CAD）和心肌炎是发病率和死亡率的主要原因。亚临床心脏病在SLE中的患病率尚不清楚。我们研究了一个全面的心血管磁共振（CMR）协议是否可能是有用的早期诊断心脏病的SLE患者没有已知的CAD。在这项前瞻性、观察性、横断面研究中，对30例无已知CAD的连续SLE患者进行CMR，包括电影、晚期钆增强（LGE）和负荷灌注序列、ECG和血液采样。所有患者均符合至少4/11的美国流变学学会（ACR）SLE分类标准。入组了30例患者（83%为女性），平均年龄为45±14岁，平均SLE病程为10±8年。80%的人有低到中度的疾病活动。所有患者的SLE损伤指数均较低。CMR异常13/30（43%），显示LGE 9/13，负荷灌注缺损5/13，心包积液（PE）7/13。非缺血性LGE患者更常出现微量白蛋白尿，而应激性灌注缺损患者有高血压史、肾脏疾病（ACR标准）、ECG复极异常和较大的LV舒张末期容积指数。临床症状与CMR结果无相关性。我们的研究表明，CMR观察到的心脏受累在SLE中很常见，不一定与典型症状相关。因此，CMR可能有助于检测亚临床心脏受累，这可能导致早期治疗。此外，我们确定了与心脏受累相关的可能风险因素。
In systemic lupus erythematosus (SLE), cardiac manifestations, e.g. coronary artery disease (CAD) and myocarditis are leading causes of morbidity and mortality. The prevalence of subclinical heart disease in SLE is unknown. We studied whether a comprehensive cardiovascular magnetic resonance (CMR) protocol may be useful for early diagnosis of heart disease in SLE patients without known CAD. In this prospective, observational, cross-sectional study CMR including cine, late gadolinium enhancement (LGE) and stress perfusion sequences, ECG, and blood sampling were performed in 30 consecutive SLE patients without known CAD. All patients fulfilled at least 4/11 American College of Rheumatology (ACR) Criteria for the classification of SLE. 30 patients (83% female) were enrolled, mean age was 45±14 years and mean SLE disease duration was 10±8 years. 80% had low to moderate disease activity. All had a low SLE damage index. CMR was abnormal in 13/30 (43%), showing LGE in 9/13, stress perfusion deficits in 5/13 and pericardial effusion (PE) in 7/13. Patients with non-ischemic LGE had more often microalbuminuria while patients with stress perfusion deficits a history of hypertension, renal disorder as ACR criterion, repolarisation abnormalities on ECG and larger LV enddiastolic volume index. There was no correlation between clinical symptoms and CMR results. Our study shows that cardiac involvement as observed by CMR is frequent in SLE and not necessarily associated with typical symptoms. CMR may thus help to detect subclinical cardiac involvement, which could lead to earlier treatment. Additionally we identify possible risk factors associated with cardiac involvement.
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影响因子：
37.8
作者：
Kwong RY;Sattar H;Wu H;Vorobiof G;Gandla V;Steel K;Siu S;Brown KA
通讯作者：
Brown KA
影响因子：
2.6
作者：
Mavrogeni, S.;Smerla, R.;Papadopoulos, G.
通讯作者：
Papadopoulos, G.
影响因子：
24
作者：
de Cobelli, F;Pieroni, M;Del Maschio, A
通讯作者：
Del Maschio, A
影响因子：
3.5
作者：
Mavrogeni, Sophie;Markousis-Mavrogenis, George;Kolovou, Genovefa
通讯作者：
Kolovou, Genovefa
影响因子：
24
作者：
Klem, I;Heitner, JF;Kim, RJ
通讯作者：
Kim, RJ