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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have studied the cardiac manifestations of connective tissue diseases. In 213 files of patients with connective tissue disease of the Department of Medicina I, Hospital Santa Maria, during 21 years. Cardiac manifestations were observed in 63 (90%) SLE. Pericarditis was the most frequent manifestation and occurred in 33 patients (43%). The cardiac manifestations were observed in 40 (41%) RA. Pericarditis appeared in 11 patients, valvulopathy in 12 patients and coronaropathy in 11 patients. In 10 of PD diagnosed patients, ECG abnormalities were the only findings. Arrhythmias, conduction disturbances, cardiac failure and coronaropathy were the cardiac manifestations of PSS in 11 patients. Polyarteritis Nodosa patients had myocardial ischemia and another had a malignant hypertension diagnosis. We found pericardial effusion in one patient and angina in another one with MCTD diagnosis. We did'nt find any cardiac manifestation in AS. Cardiac manifestations are frequent in connective tissue diseases. The ECG, ECO and pathology show abnormal findings. Although there is not clinical cardiological expression of the disease we suggest the use of ECG. ECO Holter electrocardiography and isotopic myocardial perfusion scan technics in the clinical evaluation of such patients.
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PMID:[Cardiac manifestations of connective tissue diseases]. 269 91

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

Two patients had cardiac complications of childhood onset systemic lupus erythematosus (SLE). A 14-year-old boy had extramural and intramural coronary arteritis demonstrated by angiography. The signs and symptoms of myocardial ischemia improved dramatically when corticosteroid dose and immunosuppression were increased. A 20-year-old woman had had SLE for 18 years and had functionally significant mitral stenosis and regurgitation. Calcification of the mitral valve was observed on echocardiography. Corticosteroid treatment has controlled the renal manifestations of SLE. Cardiac complications of SLE are now a significant clinical problems.
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PMID:Cardiac complications in children with systemic lupus erythematosus. 663 79

Invasive hemodynamic measurements were made in 10 supine patients with chronic refractory congestive heart failure (CHF) due to ischemic heart disease or cardiomyopathy before and after oral administration of a new arteriolar vasodilator, endralazine. In 9 patients, a 10 mg dose of endralazine produced maximal increases in cardiac and stroke volume indexes of 56 and 41%, respectively, with a 45% reduction in total systemic resistance. After a 5 mg dose of endralazine, cardiac index increased maximally by 38% and stroke volume index by 34%, with a 31% decrease in total systemic resistance. Mean arterial pressure decreased 11 +/- 4 mm Hg (mean +/- standard error of mean) with the 5 mg dose and 17 +/- 5 mm Hg after the 10 mg dose. There were no significant changes in the right atrial, pulmonary arterial, or pulmonary capillary wedge pressures. After administration of a single dose of endralazine, statistically significant hemodynamic changes were observed from 1 to 8 hours with peak responses at 3 to 4 hours. These observations suggest that endralazine has hemodynamic properties similar to those of its structural analog, hydralazine. However, endralazine metabolism is largely independent of the patients' acetylator status, and no cases of systemic lupus erythematosus have been reported after long-term oral administration. These findings suggest that endralazine may be an efficacious drug that is potentially safer than hydralazine in the treatment of chronic CHF.
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PMID:Acute hemodynamic effects of endralazine: a new vasodilator for chronic refractory congestive heart failure. 684 62

A computer-based system for storing items of medical record data including a complete coded list of diagnoses was established in 1971 for all patients admitted to a research-oriented medical ward. An analysis was made to assess the usefulness of such an electronically-stored data base from the stand-point of Unit activity, disease correlations, stability of diagnostic criteria, completeness of diagnosis lists and accuracy of coding. Over six years, 1972-77, there were 3569 admissions of which 1679 were first admissions. The most frequently made principal diagnoses were cerebrovascular accident (8%), myocardial infarction (5.4%), ischaemic heart disease (2.9%), rheumatoid arthritis (2%), duodenal ulcer (2%) and systemic lupus erythematosus (1.9%); the 33 most frequent principal diagnoses accounted for only 45% of all principal diagnoses made. The duration of stay (mean 16 days) was shown to depend on principal diagnosis but not significantly on age. Variability in annual incidence was significant for 24% of diagnoses; for some diagnoses this was readily explainable by extraneous causes, but for others it suggested an "instability" of criteria for that diagnosis. The probability of a minor diagnosis being "overlooked", using Dupuytren's contracture as an example, was shown to be high (50%). The rate of miscoding a diagnosis was 5%. This study, despite its illustration of the "softness' of diagnosis making in routine hospital ward practice, illustrates the potential or processing hospital diagnosis data by computer.
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PMID:Utility analysis of a computer stored diagnosis index and other medical record data. 693 70

To clarify the clinical spectrum of coronary arterial abnormalities in systemic lupus erythematosus, the data were reviewed on six patients who had a diagnosis of lupus at ages 15 to 29 years and who had ischemic heart disease before age 35. Two patients had coronary arteritis diagnosed on postmortem examination. In a third patient alterations in coronary arterial anatomy occurred with angiographic improvement temporally related to the initiation of steroid therapy. The other three patients had severe diffuse atherosclerotic coronary disease that was identified in two at postmortem examination. In the third patient the course of the disease strongly suggested coronary atherosclerosis, and eventually coronary bypass grafting was performed for relief of angina. In summary, clinically important extramural coronary arteritis and atherosclerosis both occur, although rarely, in young patients with lupus. Coronary artery disease may occur with or without coexisting active extracardiac lupus manifestations. Short-term steroid therapy and follow-up angiography for those with angina and in whom coronary arteritis is suspected warrant consideration. When stable coronary arterial anatomy is demonstrated on follow-up angiography, management is determined by the patient's symptoms irrespective of the prior history of lupus and, if indicated, cardiac surgery for symptomatic relief can be safely performed.
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PMID:Ischemic heart disease in systemic lupus erythematosus in the young patient: report of six cases. 697 69

Sera from 29 of 48 patients with idiopathic dilated cardiomyopathy (IDCM) and six of six patients with dilated cardiomyopathy (DCM) secondary to suspected viral myocarditis were shown to react with the branched chain alpha-ketoacid dehydrogenase (BCKD) complex mitochondrial proteins. Whereas sera from only 1 of 26 patients with ischemic heart disease showed reactivity against the BCKD complex protein, 0 of 30 sera from normal human volunteers, 0 of 64 sera from patients with lupus, and 0 of 34 sera from patients with rheumatoid arthritis showed detectable reactivity, denoting an element of specificity for the reactivity of sera from IDCM patients. The major reactivity was localized to the dihydrolipoyl transacylase (E2) component of BCKD complex. By using recombinant techniques, the immunodominant BCKD-E2 epitope recognized by sera from IDCM patients was localized to amino acid (aa) sequences 116 to 134. Each of the IDCM sera that reacted with the native BCKD complex was shown to react with the immunodominant peptide, as defined by a peptide inhibition ELISA and by an ELISA using the reactive peptide conjugated to BSA. Sera from IDCM patients that reacted with the native BCKD complex and the reactive peptide also showed inhibition of BCKD enzyme activity. The possible mechanisms for the induction of the Abs and the implications of these findings for the pathogenesis of IDCM are discussed.
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PMID:Epitope mapping of the branched chain alpha-ketoacid dehydrogenase dihydrolipoyl transacylase (BCKD-E2) protein that reacts with sera from patients with idiopathic dilated cardiomyopathy. 796 42

A 59-year-old female was admitted to our hospital because of chest pain. Coronary angiography revealed severe obstruction of the left coronary artery. The findings of hematology and renal biopsy were interpreted as showing active systemic lupus erythematosus (SLE). Coronary artery bypass grafting was performed before steroid therapy because of worsening cardiac function due to myocardial ischemia. Postoperative course had been satisfactory immediately after operation, but the patient showed pulmonary infection about two months after operation and died three months after surgery. In open heart surgery for a patient with active SLE, special care must be taken to the prevention and treatment for infection.
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PMID:[A case of coronary artery bypass grafting in a patient with active systemic lupus erythematosus]. 823 Sep 32

Eighteen consecutive patients, admitted with a diagnosis of dilated cardiomyopathy (DCM), to the Cardiology Section, Department of Internal Medicine, University Hospital, Uppsala, Sweden were enrolled into the study. All patients suffered signs of cardiac incompensation of variable duration. Patients were defined by conventional clinical investigations including chest X-ray, ultrasound, g-camera, catheterization and endomyocardial biopsy with histological evaluation by a specially trained pathologist. Angiography was performed to exclude ischemic heart disease. Several patients were diagnosed as having a specific reason for the cardiac insufficiency, like pheochromocytoma, SLE, ethylism, ischemic heart disease and hypertrophic cardiomyopathy. In this group all 7/7 had negative serology against Coxsackie B viruses. In the other group of idiopathic CM, no other etiology could be found. Serological analysis in this group showed high IgM titres against Coxsackie viruses in 6/8 patients. EDTA-blood was taken for tissue-typing using DNA probe hybridisation. 6/12 patients had DQB1:4 using the newest nomenclature, vs 17% in the control population. The reversed picture was observed for DQB1:2, occurring in 1/12 patients, vs 19% in the normal population, thus indicating a protective value of this genotype, which to our knowledge has not been described before. The results indicate a dual dependence of (host) genotype and (virus) serotype according to the Doherty-Zinkernagel hypothesis. Thus, it would also be in agreement with the virus-immune hypothesis suggested more than 20 years ago to explain the enigmatic pathogenesis of DCM.
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PMID:Genotypic and serotypic profile in dilated cardiomyopathy. 839 Jul 21

Antiphospholipid antibodies (APA) have been detected in various conditions including venous and arterial thrombosis, recurrent fetal loss, thrombocytopenia and cardiac valvular lesions. APA were initially found in patients with systemic lupus erythematosus (SLE) but later have been demonstrated also in patients without connective tissue disease. We report the extensive evaluation of a 24-year-old otherwise healthy male with APA and a family history of SLE who presented with severe ischaemic heart disease requiring coronary by-pass surgery.
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PMID:Antiphospholipid antibodies and ischaemic heart disease. 845 Feb 99


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