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)

A 21-year-old woman with a history of systemic lupus erythematosus (SLE) presented to the emergency room with a chief complaint of substernal chest pain and palpitations. She had undergone a four-vessel coronary artery bypass graft operation with separate saphenous vein grafts to the left anterior descending (LAD), obtuse marginal (OM) 1 and 2, and distal right coronary arteries (RCA) 8 months prior to admission. The patient underwent angiography of the coronary vessels, which showed severe diffuse disease with a long, 90% narrowing of the vein graft to the LAD and closed vein grafts to OM1 and OM2. The RCA graft showed mild diffuse disease. An intervention was done in which the LAD was stented twice with subsequent TIMI 3 flow. Advances in medical therapy and a better understanding of the disease have contributed to a dramatic improvement in the long-term survival of patients with SLE. However, despite the overall long-term improvement, coronary artery disease remains a major cause of morbidity and mortality with an incidence of approximately nine-fold greater than would be expected for this population.
J Invasive Cardiol 2003 Mar
PMID:Premature coronary artery disease in systemic lupus erythematosus with extensive reocclusion following coronary artery bypass surgery. 1261 93

Left main coronary aneurysm is a very rare disorder. Aneurysm may be single or multiple, saccular or fusiform. Atherosclerosis, mucocutaneous lymph node syndrome, trauma, angioplasty, atheroctomy, laser procedures, systemic lupus erythematosus, periarteritis nodosa or types of arteritis, dissection, syphilis, mycotic emboli may lead to coronary aneurysms. The main complications of coronary aneurysms are: thrombosis, distal embolisation, rupture and calcification. Operative therapy should be necessary for large left main coronary aneurysms because of their predisposition to thrombosis and embolism. The coexisting significant obstructive CAD may be important in making a decision for the operative treatment in patients with the left main coronary aneurysm. The proper type of operation is not clear.
Int J Cardiol 2003 Mar
PMID:Large atherosclerotic left main coronary aneurysm: a case report and review of literature. 1265 91

Systemic lupus erythematosus (SLE) is an inflammatory disease characterized by deposition of autoantibodies and pathogenic immune complexes in the cells and tissues of an organism, causing lesions. The heart is one of the most frequently involved organs, valvar involvement being common (27%) and of great clinical importance. Some studies suggest that valvar involvement is associated with the presence of a specific autoantibody, the antiphospholipid antibody (aPL). In these circumstances, major complications may occur such as arterial or venous thrombosis, thrombocytopenia, repeated spontaneous abortions and presence of lupus anticoagulant antibody. Among the semiologic methods for cardiac evaluation, echocardiography is the main instrument for investigating the anatomical and functional involvement of the heart in the great majority of systemic diseases like SLE. We report the case of a patient with SLE and aPL syndrome who underwent surgery for mitral valve replacement with a biological prosthesis and died nine months later due to massive intracardiac thrombosis and prosthesis dysfunction.
Rev Port Cardiol 2003 Feb
PMID:Intracardiac thrombosis and mitral prosthesis dysfunction in systemic lupus erythematosus. A case report. 1276 1

Echocardiographic-guided pericardiocentesis was found to be safe and efficacious in treating 11 patients with systemic lupus erythematosus who had hemodynamically significant pericardial effusions. These patients tended to present early in their disease course, and men were more often affected.
Am J Cardiol 2003 Dec 01
PMID:Clinical and echocardiographic characteristics of hemodynamically significant pericardial effusions in patients with systemic lupus erythematosus. 1463 28

The main purpose of the study was to evaluate the utility of technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography (Tc-99m sestamibi SPECT) in detection of cardiac involvement in systemic lupus erythematosus (SLE) or systemic sclerosis (SS) patients. Fifty SLE or SS female patients with cardiac symptom/sign such as chest discomfort and/or dyspnea and/or occasionally palpitation and 50 SLE or SS female patients without any cardiac symptom/sign were investigated using Tc-99m sestamibi SPECT during rest and stress after dipyridamole infusion. Twenty-five age- and sex-matched healthy females were also included as controls in this study. The results of Tc-99m sestamibi SPECT were classified into four types including normal, persistent perfusion defect (PD), reversible perfusion defect (RD), and reverse perfusion defect (RR). The results of Tc-99m sestamibi SPECT in the 25 healthy females were normal. Perfusion abnormalities were detected in 44/50 (88%) symptomatic SLE or SS patients. However, myocardial perfusion abnormalities were only detected in 19/50 (38%) asymptomatic SLE or SS patients (P value<0.05 by a chi2 test). However, for risk factor of coronary artery disease and abnormal resting EKG, the incidences were not significant between symptomatic and asymptomatic patients (P values >0.05 by a chi2 test). Tc-99m sestamibi SPECT is a useful noninvasive imaging modality to detect cardiac involvement in symptomatic or asymptomatic SLE or SS patients.
Int J Cardiol 2003 Dec
PMID:Usefulness of technetium-99m sestamibi myocardial perfusion SPECT in detection of cardiovascular involvement in patients with systemic lupus erythematosus or systemic sclerosis. 1465 47

We explored the association between diagnosed rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) and the risk of developing a first-time acute myocardial infarction (AMI) by conducting a population-based, case-control analysis using data from the United Kingdom-based General Practice Research Database (GPRD). Among 8,688 patients with AMI and 33,329 matched controls, the adjusted odds ratio (ORs) of AMI for subjects with RA was 1.47 (95% confidence interval [CI] 1.23 to 1.76), and in subjects with both RA and diagnosed hyperlipidemia, the OR was 7.12 (95% CI 4.16 to 12.18). The risk associated with SLE was 2.67 (95% CI 1.34 to 5.34). These results underline that RA and SLE increase the risk of AMI.
Am J Cardiol 2004 Jan 15
PMID:Effect of rheumatoid arthritis or systemic lupus erythematosus on the risk of first-time acute myocardial infarction. 1546 98

Giant cell myocarditis (GCM) is a rare and frequently fatal disorder with no proven treatment. It is a disease of young, predominantly healthy adults. Without transplantation, patients usually die of heart failure and ventricular arrhythmias. Due to the poor prognosis of the condition, prompt recognition and diagnosis are of clinical importance. Approximately 19% of these cases are associated with autoimmune diseases. The present article describes two unique cases of GCM associated with autoimmune diseases not previously reported in the literature - discoid lupus erythematosis and autoimmune hepatitis. A review of the natural history and treatment of GCM is also presented.
Can J Cardiol 2004 Apr
PMID:Novel associations of giant cell myocarditis: two case reports and a review of the literature. 1510 Jul 60

Large increases in mortality related to premature atherosclerosis with coronary artery disease have been reported in patients with systemic lupus erythematosus (SLE). The current pathogenic hypothesis for atherosclerosis involves not only the classic factors identified in the Framingham study, but also includes chronic inflammation, corticosteroid therapy, excess of traditional risk factors, autoantibodies, immune complexes (containing antibodies to phospholipids, to oxidized low-density lipoproteins, and to endothelial cells), and cytokine-producing activated T cells. Early risk factor intervention and effective control of inflammation should be incorporated into the management of SLE to protect against atherosclerosis.
Cardiol Rev
PMID:Atherosclerosis and systemic lupus erythematosus. 1531 7

The patient is a 34-year-old female with systemic lupus erythematosus and secondary antiphospholipid antibody syndrome, who evolved with convulsive crises, partially controlled with an anticonvulsant, and auscultation of a cardiac murmur, whose investigation showed the presence of a mitral valve vegetation. Once the diagnosis of Libman-Sacks endocarditis was established, therapy with warfarin sodium was initiated, and, after 6 months of oral anticoagulation, the patient had total control of the convulsive crises and the valvular vegetation disappeared on echocardiography. This study discusses the occurrence of Libman-Sacks endocarditis in systemic lupus erythematosus, its association with antiphospholipid antibody syndrome, and the anticoagulant therapy. A literature review is also provided.
Arq Bras Cardiol 2004 Apr
PMID:Libman-Sacks endocarditis and oral anticoagulation. 1532 May 58

A significant correlation between autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and premature or accelerated coronary atherosclerosis was found. The objectives of the study were: a) evaluate myocardial perfusion in patients with rheumatic diseases by means of contrast echocardiography (CE) and to establish its usefulness as compared to the results obtained by nuclear medicine (NM) (reference method). b) evaluate the prevalence of alterations in subclinical myocardial perfusion in autoimmune diseases and to establish a strategy to evaluate the cardiovascular changes in this disease. Myocardial perfusion in 37 outpatients of the rheumatology department was evaluated by CE at rest and with pharmacological stress (dobutamine) and NM. The prevalence of alterations in the myocardial perfusion in autoimmune diseases by CE and NM, when these methods were analyzed independently or when both methods were used was 27%. The positive predictive value (PPV) and negative predictive value (NPV) of both tests was 80% and 93%, respectively, the sensitivity was 80% and the specificity was 93%. The prevalence of alterations of perfusion in the primary antiphospholipid syndrome (PAPS) was of 30%. In this patients it was found that when both diagnostic tests are performed, NM reaches a sensitivity of 100% if the CE is positive and an specificity of 100% when the CE is negative. We can conclude that it is important to determine the presence of subclinic coronary artery disease in patients with autoimmune disease by noninvasive studies such as Sestamibi SPECT and/or CE for assessment of myocardial perfusion in order to plan an adequate treatment and follow-up.
Arch Cardiol Mex
PMID:[Analysis of the ulsefulnes of contrast echocardiography and nuclear medicine in cardiovascular affection due to autoimmune diseases]. 1590 39


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