Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

ECG changes in 49 patients with rheumatoid arthritis, 18 with ankylosing spondylitis, 47 with systemic lupus erythematosus, 17 with dermatomyositis, 21 with scleroderma and 7 with polyarteritis nodosa were compared with ECG changes in 106 control subjects. The classification of ECG findings was based mainly on the Minnesota Code. Compared with control subjects, pathological Q--QS, ST segment and T wave patterns were more common in all patient groups--including dermatomyositis, in which cardiac involvement has rarely been reported. P terminal force (PTF) was higher in the patient group. Conduction defects were probably more common in connective tissue diseases, whereas differences in ectopic beats, arrhythmias, QRS duration and QRS axis and R wave amplitude were not significant. The only significant difference between the steroid-treated patients and those without such treatment was the higher frequency of ST changes in the steroid-treated group. The results imply that heart affection is common in all connective tissue diseases. The several mechanisms underlying the cardiac involvement are reflected in many ways in the electrocardiograms of these patients, including an increased frequency of ECG changes mimicking those met in coronary heart disease.
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PMID:Electrocardiographic findings in patients with connective tissue disease. 3 14

The lower incidence of coronary heart disease in populations consuming polyunsaturated fatty acids has spurred interest in the possible cardioprotective nature of these fatty acids. Furthermore, the source of dietary fats may modify the natural history of some chronic inflammatory disorders such as rheumatoid arthritis and systemic lupus erythematosus. Some studies examining these issues have involved animals fed a standard chow diet to which the desired fatty acids were added. Our observation that two lots of standard rat chow varied considerably in fatty acid composition, prompted us to analyze two additional standard rat chow lots for fatty acid composition. Each lot was extracted and fatty acid chain length determined by gas chromatography with the percentage of total fatty acids determined by integration. A wide variation in the total saturated (27.4-42.1%), monounsaturated (8.3-30.9%), omega 6 (17.2-44.2%), and omega 3 (3.8-11.2%) fatty acids was observed. By one-way analysis of variance, significant differences (p less than 0.025) between the various lots were observed for total saturated, monounsaturated, and omega 6 fatty acid groups. These findings suggest that fatty acid composition of standard rat chow is not similar. If the baseline fatty acid composition is critical to the experimental design, custom chow diets should be used.
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PMID:Dissimilar fatty acid composition of standard rat chow. 281 86

SLE affects most aspects of cardiac function, and recent studies have reported increasing cardiovascular morbidity and mortality. Pathologically, SLE is characterized by a pancarditis involving pericardium, myocardium, endocardium, and coronary arteries. In autopsy series, pericarditis has been found in 43% to 100% (mean 62%, Table I), and myocarditis was found in 8% to 78% (mean 40%, Table II), but both have been underdiagnosed clinically. Libman-Sacks lesions have been noted in 25% to 100% (mean 43%) and infective endocarditis in 1.1% to 4.9% of clinical and autopsy studies (Table III). Coronary disease may be due to arteritis, which should be treated with high-dose steroids, or it may be due to atherosclerosis, which is amenable to medical or surgical therapy. Valvular disease has been treated surgically, but with a combined surgical mortality as high as 25%. Aortic insufficiency and mitral regurgitation are the most common valvular problems, although aortic and mitral stenosis have also been reported. Hypertension has been noted in 14% to 69%, and heart failure in 5% to 44%. Evidence for a lupus cardiomyopathy, which may be subclinical, is reviewed. While steroids may ameliorate SLE pancarditis, they have also been associated with hypertension, LV hypertrophy, purulent and constrictive pericarditis, mitral regurgitation, and perhaps accelerated atherosclerosis. It remains to be seen if improved diagnosis and treatment of the cardiovascular manifestations of SLE can enhance survival.
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PMID:Cardiovascular manifestations of systemic lupus erythematosus. 390 17

One hundred consecutive female patients with active systemic lupus erythematosus (SLE) were studied from the cardiovascular point of view by means of non invasive methods. Seventy percent of the cases presented some type of cardiovascular anomaly. Seventy four percent of the resting electrocardiograms were abnormal as well as 72% of the M mode echocardiograms and 55% of the cardiac X ray series. The most frequent observed complications were: pericarditis and or pericardial effusion (39%), arterial hypertension (22%), ischemic heart disease (16%), myocarditis (14%), congestive heart failure (10%), pulmonary hypertension (9%), valvular heart disease (9%), pleural effusion (7%) and cerebro vascular accident (3%). We analyzed each one of these complications and found of special interest the high incidence of ischemic heart disease which is more frequent than has been hitherto reported. Ischemic heart disease was observed in two types of patients: a) Those with long term steroid therapy. In these, the mechanism seems to be an atherosclerotic disease probably induced by the chronic use of steroids. The management of these cases do not differ from other types of coronary heart disease due to atherosclerosis. b) Those with frank episodes of vasculitis in whom the basic mechanism is an inflammatory process of the coronary arteries and its treatment is fundamentally that of the vasculitis. We consider necessary to study routinely all patients with SLE through non invasive cardiological methods.
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PMID:Cardiovascular manifestations in systemic lupus erythematosus. Prospective study of 100 patients. 402 48

In a population sample in whom violent accident was the cause of death, the following prevalence of coronary intimal necrosis, occurring as an independent lesion and as an early step of atherosclerotic involvement, was revealed: 2% of children 6--10 years old, 6% of children and juveniles 11--15 years old, 14% of adolescents 16--20 years old, 32% of young adults 21--25 years old, 56% of young adults 26--30 years old, 72% of mature adults 31--35 years old and 84% of mature adults 36--40 years old. In each age subgroup, the percentage of subjects with coronary intimal necrosis was greater than the percentage of subjects with coronary atherosclerotic plaques. A centrifugal extension with age of intimal necrosis, along the coronary tree in the direction of blood flow, was observed. Histologically, the coronary intimal necrosis exhibited a mucoid form, a swelling form and a dissecting form. Indirect evidence was offered that some areas of coronary intimal necrosis formed an adequate nidus for lipid and fibrin accumulation and also induced the development of a peculiar type of subendothelial connective tissue. These successive changes led to the onset of atheroma-like lesions with a prevalence of lipid deposits, or of intramural thrombi or of a fibro-hyaline cap. The onset, extent and evolution of coronary intimal necrosis was accelerated by the male sex, by some minor deviations from the basal branching anatomical pattern of the coronary arteries, by the main risk factors for coronary heart disease, as well as by some terminal diseases, such as the generalized form of sarcoidosis and the renal complications of systemic lupus erythematosus.
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PMID:Coronary intimal necrosis occurring as an early stage of atherosclerotic involvement. 725 28

We present the clinical case of a 26-year-old woman, suffering systemic lupus erythematosus for 15 years, who suddenly had coronary heart disease with angina pectoris on mild effort. Thallium 201 exercise test demonstrated clearcut anteroseptal and apical perfusion defects, whereas repeated echocardiography showed a hypokinetic anteroseptal segment; ECG also reported new Q wave in lead V4. After stronger corticosteroid and immunosuppressive treatment, angina pectoris attenuated and perfusion defects disappeared within few months. We hypothesize a coronary artery vasculitis in the course of systemic lupus erythematosus, probably associated with early coronary artery atherosclerosis.
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PMID:[Critical myocardial ischemia in systemic lupus erythematosus. Case report]. 797 32

An examination has been carried out of 46 patients (33 females, 13 males, a mean age 40) with Sneddon's syndrome characterized by cerebrovascular disturbances and marked livedo. A clinical spectrum of the syndrome included miscarriage and intrauterine death of the fetus (20 cases), peripheral vein thromboses (12 cases), coronary heart disease (18 cases), thrombocytopenia (8 cases), arterial hypertension (27 cases), headache (39 cases), epileptic seizures (5 cases). Similar manifestations are usually seen in antiphospholipid syndrome (AFLS). Antibodies to phospholipids, those to cardiolipin, lupus anticoagulant were detectable in 78, 50 and 61% of the cases, respectively. Clinical and immunological signs of AFLS in the absence of SLE-typical symptoms provided grounds for considering them primary AFLS. Similar clinical patterns in 36 patients with cardiolipin antibodies and/or lupus anticoagulant and 10 patients without the antibodies and anticoagulant suggest these cases to be AFLS too.
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PMID:[Sneddon's syndrome and the primary antiphospholipid syndrome]. 805 89

Patients with nephrotic syndrome (NS) are believed to be at increased risk of atherosclerosis and coronary heart disease (CHD), although existing evidence for this association has not been persuasive. The risk of CHD among 142 persons with NS documented by protein-uria > or = 3.5 g daily was compared with that among 142 matched controls randomly selected from the membership of a large Northern California health plan. Controls were matched for sex, year of birth, and presence in the health plan when the referent case was diagnosed. No diabetics were included in this study. Mean follow-up for nonfatal CHD events was 5.6 years for NS subjects and 11.2 years for controls. Among the NS subjects myocardial infarction (MI) developed in 11, and there were 58 deaths, seven because of CHD. Among the controls, there were four MIs and 10 deaths, three because of CHD. In matched-pair analysis, there were 11 MIs among NS subjects and none among controls [P = 0.001, lower bound of 95% confidence interval for relative risk (CI), 2.8]. In an unmatched analysis adjusted for hypertension and smoking at diagnosis of NS, the relative risk of MI was 5.5 (95% CI 1.6 to 18.3) and the relative risk of coronary death was 2.8 (95% CI 0.7 to 11.3). Omitting data of NS subjects with minimal change disease and systemic lupus erythematosus yielded similar results. These data suggest that persons with NS are at increased risk of CHD.
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PMID:The increased risk of coronary heart disease associated with nephrotic syndrome. 823 Oct 39

Gemfibrozil improves lipid and apolipoprotein profiles, particularly very low density lipoprotein (VLDL) triglyceride and high density lipoprotein (HDL) cholesterol levels, in patients with dyslipidaemia when administered at a total daily dose of 900 or 1200 mg. As demonstrated by the Helsinki Heart Study, these effects result in a reduction in some risk factors for coronary heart disease (CHD) and also a 34% reduction in the incidence of this disease after 5 years compared with placebo. Limited data suggest that gemfibrozil has beneficial effects on the fibrinolytic system and may slow the progression of atherosclerosis. Gemfibrozil has shown efficacy in the treatment of patients with type IIa, IIb, III, IV or V dyslipidaemia or hypoalphalipoproteinaemia, especially in patients with elevated triglyceride and low HDL cholesterol levels. It is also effective in patients with non-insulin-dependent diabetes mellitus (NIDDM) and dyslipidaemia and has no detrimental effects on glycaemic control. A small number of studies also showed gemfibrozil to be effective for the control of dyslipidaemia associated with renal failure, transplantation, nephrotic syndrome, arterial occlusive disease or systemic lupus erythematosus. However, patients with pre-existing CHD do not appear to derive the same benefits (reduced CHD mortality) from gemfibrozil therapy as these other patients, although results are based on studies of limited size and number. In general, gemfibrozil has at least similar efficacy to bile acid sequestrants and other fibric acid derivatives. Comparisons with HMG-CoA reductase inhibitors show these agents to produce different effects on lipid profiles from gemfibrozil. Thus, gemfibrozil would be expected to be superior in some patients (those with elevated triglyceride or VLDL cholesterol levels), but HMG-CoA reductase inhibitors should have greater benefits in those with elevated low density lipoprotein cholesterol levels. Thus, in patients with elevated triglyceride levels and low HDL cholesterol levels, and, particularly in patients with NIDDM, gemfibrozil is a useful treatment option, which has been shown to reduce the risk of CHD in middle aged men. However, limited available data prevents the accurate comparison of this agent with HMG-CoA reductase inhibitors in patients with this lipid profile.
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PMID:Gemfibrozil. A reappraisal of its pharmacological properties and place in the management of dyslipidaemia. 873 20

Essential fatty acids (EFAs) form an important component of cell membranes, are eicosanoid precursors and are therefore required for both the structure and function of every cell in the body. EFAs can modulate the activity of protein kinase C, T and B cell response, free radical generation and lipid peroxidation, lymphokine secretion and cell proliferation. EFAs also have anti-mutagenic, anti-bacterial, anti-fungal and anti-viral properties. EFAs and their metabolites lower serum cholesterol, triglycerides and blood pressure. EFAs appear to be of benefit in atopic eczema, premenstrual syndrome, psoriasis, auto-immune disorders especially rheumatoid arthritis and systemic lupus erythematosus, prevention of target organ damage in diabetes mellitus, peptic ulcer disease, ulcerative colitis, coronary heart disease and atherosclerosis. EFAs and their metabolites can selectively kill tumor cells both in vitro and in vivo without harming normal cells. In addition, EFAs seem to play a fundamental role in inflammation and immune response. In view of their actions and relative safety, it is anticipated that EFAs may be useful in the management of several diseases.
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PMID:Essential fatty acids in health and disease. 1077 63


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