OBJECTIVE: Heart pathology strongly influences the course and prognosis of patients with generalized autoimmune diseases. In spite of autoimmunity being a common denominator of these diseases, systemic sclerosis (SSc), systemic lupus erythematosus (SLE) and dermato/polymyositis (DPM) differ significantly in the pathogenesis of organ damage. The aim of the study was to compare pathologic changes in heart structure and function in these diseases by means of standard echocardiography and tissue Doppler (TDE). MATERIAL AND METHODS: Four groups were examined: 60 SSc, 60 SLE and 15 DPM patients in stable clinical conditions and 30 healthy control subjects. Echocardiography with TDE was performed with the assessment of systolic (S) and diastolic (E) velocities of mitral and tricuspid annuli. RESULTS: Heart in SSc was characterized by significant diastolic left ventricular dysfunction (mitral E 8.61 +/- 2.3 cm/s vs. 12.4 +/- 3.5 cm/s in the control group; P < 0.01) with preserved systolic function (mitral S 7.85 +/- 1.5 cm/s vs. 7.95 +/- 0.9 cm/s in control group; ns). SLE and DPM resulted mainly in pathologic thickening of valvular leaflets and/or pericardium [mitral or aortic leaflets thickened in 38 (63.3%) of SLE patients, 7 (46.7%) of DPM patients; pericardium thickened in 36 (60%) of SLE patients]. Pulmonary capillary wedge pressure was elevated in SSc (13.8 +/- 3.5 mmHg) and DPM (13.2 +/- 2.5 mmHg) patients as compared to the control group (9.2 +/- 3.7 mmHg, P < 0.01). Right ventricular systolic and diastolic dysfunction was frequent irrespective of the presence or absence of pulmonary hypertension. CONCLUSIONS: Echocardiography with TDE reveals characteristic pathology in different forms of generalized autoimmune diseases reflecting their different pathogenetic mechanisms. Overproduction of collagen in SSc results in diastolic left ventricular dysfunction, while generalized inflammation in SLE and DPM leads mainly to pathologic changes on valvular leaflets and/or pericardium. Interestingly, right ventricular dysfunction is common in all diseases analyzed, regardless of the presence of pulmonary hypertension. Echocardiography, preferably with TDE, could add valuable information about usually asymptomatic heart pathology in an individual patient with generalized autoimmune disease.
OBJECTIVE: Heart pathology strongly influences the course and prognosis of patients with generalized autoimmune diseases. In spite of autoimmunity being a common denominator of these diseases, systemic sclerosis (SSc), systemic lupus erythematosus (SLE) and dermato/polymyositis (DPM) differ significantly in the pathogenesis of organ damage. The aim of the study was to compare pathologic changes in heart structure and function in these diseases by means of standard echocardiography and tissue Doppler (TDE). MATERIAL AND METHODS: Four groups were examined: 60 SSc, 60 SLE and 15 DPM patients in stable clinical conditions and 30 healthy control subjects. Echocardiography with TDE was performed with the assessment of systolic (S) and diastolic (E) velocities of mitral and tricuspid annuli. RESULTS: Heart in SSc was characterized by significant diastolic left ventricular dysfunction (mitral E 8.61 +/- 2.3 cm/s vs. 12.4 +/- 3.5 cm/s in the control group; P < 0.01) with preserved systolic function (mitral S 7.85 +/- 1.5 cm/s vs. 7.95 +/- 0.9 cm/s in control group; ns). SLE and DPM resulted mainly in pathologic thickening of valvular leaflets and/or pericardium [mitral or aortic leaflets thickened in 38 (63.3%) of SLEpatients, 7 (46.7%) of DPM patients; pericardium thickened in 36 (60%) of SLEpatients]. Pulmonary capillary wedge pressure was elevated in SSc (13.8 +/- 3.5 mmHg) and DPM (13.2 +/- 2.5 mmHg) patients as compared to the control group (9.2 +/- 3.7 mmHg, P < 0.01). Right ventricular systolic and diastolic dysfunction was frequent irrespective of the presence or absence of pulmonary hypertension. CONCLUSIONS: Echocardiography with TDE reveals characteristic pathology in different forms of generalized autoimmune diseases reflecting their different pathogenetic mechanisms. Overproduction of collagen in SSc results in diastolic left ventricular dysfunction, while generalized inflammation in SLE and DPM leads mainly to pathologic changes on valvular leaflets and/or pericardium. Interestingly, right ventricular dysfunction is common in all diseases analyzed, regardless of the presence of pulmonary hypertension. Echocardiography, preferably with TDE, could add valuable information about usually asymptomatic heart pathology in an individual patient with generalized autoimmune disease.
Authors: Steven E Lipshultz; Nao Sasaki; Bruce Thompson; Benjamin W Eidem; Irene Cheng; Steven D Colan; Sharon E O'Brien; Shahnawaz Amdani; William T Shearer; Endel John Orav; Tracie L Miller; James D Wilkinson Journal: AIDS Date: 2020-03-15 Impact factor: 4.177
Authors: Luis Miguel Blasco Mata; Olga Acha Salazar; Carmen Rosa González-Fernández; Francisco Novo Robledo; Enrique Pérez-Llantada Amunárriz Journal: Clin Dev Immunol Date: 2011-09-21
Authors: Alberico Del Torto; Andrea Igoren Guaricci; Francesca Pomarico; Marco Guglielmo; Laura Fusini; Francesco Monitillo; Daniela Santoro; Monica Vannini; Alexia Rossi; Giuseppe Muscogiuri; Andrea Baggiano; Gianluca Pontone Journal: Front Cardiovasc Med Date: 2022-03-09
Authors: Lilia M Sierra-Galan; Mona Bhatia; Angel Leovigildo Alberto-Delgado; Javier Madrazo-Shiordia; Carlos Salcido; Bernardo Santoyo; Eduardo Martinez; Maria Elena Soto Journal: Front Cardiovasc Med Date: 2022-07-13
Authors: Steven E Lipshultz; Tracie L Miller; James D Wilkinson; Gwendolyn B Scott; Gabriel Somarriba; Thomas R Cochran; Stacy D Fisher Journal: J Int AIDS Soc Date: 2013-06-18 Impact factor: 5.396
Authors: Marina Carneiro de Freitas Roque; Percival D Sampaio-Barros; Ana Lucia Arruda; Sergio Barros-Gomes; Derly Becker; José Lazaro de Andrade; Ana Clara Tude Rodrigues Journal: Arq Bras Cardiol Date: 2017-10-02 Impact factor: 2.000