Skip to main content
SpringerLink
Log in

Echocardiographic findings, lipids and lipoprotein(a) in patients with systemic lupus erythematosus

  • Originals
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Summary

Cardiac involvement, evaluated by echo-doppler-cardiography, occurred in 41 of 50 (82%) patients with systemic lupus erythematosus (SLE). Valvular pathology with aortic cusp sclerosis was the most prevalent finding irrespective of age. This finding, suggestive of atherosclerotic heart disease, was supported by increased levels of cholesterol and triglycerides in these patients. There was no significant increase in Lp(a) in the whole patient group, but Lp(a) was raised in patients with proteinuria. Forty percent of the SLE patients had pericarditis. Twelve patients with hypertension and/or mitral regurgitation had increased dimensions of left ventricle, left atrium or interventricular septum while 15 of 50 patients had isolated increase of these parameters. Localized hypokinesia was found in nine patients. Reduced cardiac index was found in five patients with SLE. There was no association between valvular disease, increased pulmonary artery pressure, and anticardiolipin antibodies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mandell BF. Cardiovascular involvement in systemic lupus erythematosus. Sem Arthritis Rheum 1987; XVII: 126–41.

    Article  Google Scholar 

  2. Urowitz MB, Bookman AAM, Koehler BE, Gordon DE, Smythe HA, Ogryzlo MA. The bimodal mortality pattern of systemic lupus erythematosus. Am J Med 1976; 60:221–5.

    Article  PubMed  Google Scholar 

  3. Badui E, Garcia-Rubi D, Robles E, Jimenez J, Juan L, Deleze M, Diaz A, Mintz G. Cardiovascular manifestations in systemic lupus erythematosus. Prospective study of 100 patients. Angiology. J Vascular Dis 1985; 36:431–41.

    Google Scholar 

  4. Jonssen H, Nived O, Sturfelt G. Outcome in systemic lupus erythematosus: A prospective study of patients from a defined population. Medicine 1989; 68: 141–50.

    PubMed  Google Scholar 

  5. Petri M, Perez-Gutthann S, Spence D, Hochberg MC. Risk factors for coronary artery disease in patients with systemic lupus erythematosus. Am J Med 1992; 93: 513–9.

    Article  PubMed  Google Scholar 

  6. Rosner S, Ginzler EM, Diamond HS, Weiner M, Schlesinger M, Fries JF, et al. A multicenter study of outcome in systemic lupus erythematosus. Arthritis Rheum 1982; 25: 612–17.

    PubMed  Google Scholar 

  7. Cronin ME, Biswas RM, Straeton van der C, Fleisher TA, Klippel JH. IgG and IgM antibodies in patients with lupus with anticardiolipin antibody associated clinical syndromes. J Rheumatol 1988; 15: 795–8.

    PubMed  Google Scholar 

  8. Khamashta MA, Cervera R, Asheron RA, Font J, Gil A, Coltart DJ, Vázquez JJ, Paré C, Ingelmo M, Oliver J, Hughes GRV. Association of antibodies against phsopholipids with heart valve disease in systemic lupus erythematosus. Lancet 1990; 335:1541–4.

    Article  PubMed  Google Scholar 

  9. Nihoyannopoulos P, Gomez PM, Joshi J, Loizou S, Walport MJ, Oakley CM. Cardiac abnormalities in systemic lupus erythematosus. Circulation 1990; 82: 369–75.

    PubMed  Google Scholar 

  10. Miller GJ, Miller NE. Plasma high-density-lipoprotein concentration and development of ischaemic heart-disease. Lancet 1975; i: 16–9.

    Article  Google Scholar 

  11. Gordon T, Kannel WB, Castelli WP, Dawber TR. Lipoproteins, cardiovascular disease and death. The Framingham study. Arch Intern Med 1981; 141: 1128–31.

    Article  PubMed  Google Scholar 

  12. Carlsson LA, Böttiger LE. Ischaemic heart-disease in relation to fasting values of plasma triglycerides and cholesterol. Lancet 1972; i:865–68.

    Article  Google Scholar 

  13. Patsch JR, Miesenböck G, Hopferwieser T, Mühlberger V, Knapp E, Dunn JK, Gotto Jr AM, Patsch W. Relation of triglyceride metabolism and coronary artery disease. Studies in the postprandial state. Arteriosclerosis and Thrombosis 1992; 12:1336–45.

    PubMed  Google Scholar 

  14. Dahlén GH. Lp(a) lipoprotein in cardiovascular disease. Review article and viewpoint. Atherosclerosis 1994; 108: 111–26.

    Article  PubMed  Google Scholar 

  15. Illowite NT, Samuel P, Ginzler E, Jacobson MS. Dyslipiproteinemia in pediatric systemic lupus erythematosus. Arthritis Rheum 1988; 31: 859–63.

    PubMed  Google Scholar 

  16. Mac Gregor AJ, Dhillon VB, Binder A, Forte CA, Knight BC, Betteridge DJ, Isenberg DA. Fasting lipids and anticardiolipin antibodies as risk factors for vascular disease in systemic lupus erythematosus. Ann Rheum Dis 1992; 51:152–5.

    PubMed  Google Scholar 

  17. Borba EF, Santos RD, Bonfa E, Vinagre CG, Pileggi FJC, Cossermelli W, Maranhao RC. Lipoprotein(a) levels in systemic lupus erythematosus. J Rheumatol 1994; 21:220–3.

    PubMed  Google Scholar 

  18. Ettinger WH, Goldberg AP, Applebaum-Bowden D, Hazzard WR. Dyslipoproteinemia in systemic lupus erythematosus. Am J Med 1987; 83: 503–8.

    Article  PubMed  Google Scholar 

  19. Leong KH, Koh ET, Feng PH, Boey ML. Lipid profiles in patients with systemic lupus erythematosus. J Rheumatol 1994; 21:1264–7.

    PubMed  Google Scholar 

  20. Karádi I, Romics L, Pálos G, Domán J, Kaszás I, Hesz A, Kostner GM. Lp(a) Lipoprotein concentration in serum with heavy proteinuria of different origin. Clin Chem 1989; 35:2121–3.

    PubMed  Google Scholar 

  21. Joles JA, Kaysen GA. Lipid metabolism in the nephrotic syndrome. In: Keane WF, Stein JH. eds. Lipids and renal disease. Contemporary issues in nephrology vol 24., New York, Churchil Livingstone Inc., 1991: 63–84.

    Google Scholar 

  22. Bulkley BH, Roberts WC. The heart in systemic lupus erythematosus and the changes induced in it by corticosteroid therapy. A study of 36 necropsy patients. Am J Med 1975; 58: 243–64.

    Article  PubMed  Google Scholar 

  23. Tan EM, Cohen AS, Fries JF. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25: 1271–7.

    PubMed  Google Scholar 

  24. Sahn DJ, De Maria A, Kisslo J, Weyman A. Recommendations regarding quantification in M-mode echocardiography: Results of a survey of echocardiography measurements. Circulation 1978; 58:1073–83.

    Google Scholar 

  25. Henry WL. De Maria A, Gramiak R, King DL, Kisslo JA, Popp RL, Sahn DJ, Schiller NB, Tajik A, Teichholz LE, Weyman AE. Report of the American Society of Echocardiography Committee on nomenclature and standards in two-dimensional echocardiography. Circulation 1980; 62:212–17.

    PubMed  Google Scholar 

  26. Prakash R. Determination of right ventricular wall thickness in systole and diastole. Echocardiographic and necropsy correlation in patients. Br Heart J 1978; 40:1257–61.

    PubMed  Google Scholar 

  27. Gardin JM, Henry WL, Savage DD, Ware JH, Burn C, Borer JS. Echocardiographic measurements in normal subjects: evaluation of an adult population without clinically apparent heart disease. J Clin Ultrasound 1979; 7:439–47.

    PubMed  Google Scholar 

  28. Herman MV, Heinle RA, Klein MD, Gorlin R. Localized disorders in myocardial contraction. Asynergy and its role in congestive heart failure. N Engl J Med 1967; 277:222–32.

    PubMed  Google Scholar 

  29. Hatle LK, Appleton CP, Popp RL. Differentiation of constrictive pericarditis and restrictive cardiomyopathy by doppler echocardiography. Circulation 1989; 79:357–70.

    Google Scholar 

  30. Lewis JF Kuo LC, Nelson JG, Limacher MC, Quinones MA. Pulsed doppler echocardiographic determination of stroke volume and cardiacoutput: clinical validation of two new methods using the apical window. Circulation 1984; 70:425–31.

    PubMed  Google Scholar 

  31. Harris EN, Gharavi AE, Hughes GRV. Anticardiolipin antibody testing: the need for standardization. Arthritis Rheum 1987; 30: 835–7.

    PubMed  Google Scholar 

  32. Homma M, Tojo T, Akizuki M, Yamagata H. Criteria for Sjögren's syndrome in Japan. Scand J Rheumatol 1986; suppl 61, 26–7.

    Google Scholar 

  33. Urowitz MB, Gladnan DD, Tozman ECS et al. The lupus activity criteria count (LACC). J Rheumatol 1984; 11: 783–7.

    PubMed  Google Scholar 

  34. Sturfelt G, Eskilsson J, Nived O, Truedsson L, Valind S. Cardiovascular disease in systemic lupus erythematosus. A study of 75 patients from a defined population. Medicine 1992; 71: 216–23.

    PubMed  Google Scholar 

  35. Libman E, Sachs B. A hitherto undescribed form of valvular and mural endocarditis. Arch Intern Med 1924; 33:701–15.

    Google Scholar 

  36. Leung W-H, Wong K-L, Lau C-P, Wong C-K, Cheng C-H. Cardiac abnormalities in systemic lupus erythematosus: a prospective M-mode, cross- sectional and doppler echocardiographic study. Int J Cardiol 1990; 27: 367–75.

    Article  PubMed  Google Scholar 

  37. Crozier IG, Li E, Milne MJ, Nicholesterolls MG. Cardiac involvement in systemic lupus erythematosus detected by echocardiography. Am J Cardiol 1990; 65: 1145–8.

    Article  PubMed  Google Scholar 

  38. Roldan CA, Shively BK, Lau CC, Gurule FT, Smith EA, Crawford MH. Systemic lupus erythematosus valve disease by transesophageal echocardiography and the role of antiphospholipid antibodies. J Am Coll Cardiol 1992; 20: 1127–34.

    PubMed  Google Scholar 

  39. Lahita RG, Rivkin E, Cavanagh I, Romano P. 1 Low levels of total cholesterol, high-density lipoprotein, and apolipoprotein A1 in association with anticardiolipin antibodies in patients with systemic lupus erythematosus. Arthritis Rheum 1993; 36: 1566–74.

    PubMed  Google Scholar 

  40. Sundell BI, Nilsson TK, Hallmans G, Hellsten G, Dahlén GH. Interrelationships between plasma levels of plasminogen activator inhibitor, tissue plasminogen activator, lipoprotein (a) and established cardiovascular risk factors in a North Swedish population. Atherosclerosis 1989; 80: 9–16.

    Article  PubMed  Google Scholar 

  41. Matsuda J, Gotoh M, Gohchi K, Saitoh N, Tsukamoto M. Serum lipoprotein(a) level is increased in patients with systemic lupus erythematosus irrespective of positivity of antiphospholipid antibodies. Thrombosis Research 1994; 73:83–4.

    Article  PubMed  Google Scholar 

  42. Cohen JC, Chiesa G, Hobbs HH. Sequence polymorphisms in the apolipoprotein(a) gene. J Clin Invest 1993; 91:1630–6.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Rheumatology, University Hospital, S-901 85, Umeå, Sweden

    S. Rantapää-Dahlqvist & G. Neumann-Andersen

  2. Clinical Physiology, University Hospital, S-901 85, Umeå, Sweden

    C. Backman

  3. Clinical Chemistry, University Hospital, S-901 85, Umeå, Sweden

    G. Dahlén

  4. Internal Medicine, University Hospital, S-901 85, Umeå, Sweden

    B. Stegmayr

Authors
  1. S. Rantapää-Dahlqvist
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Neumann-Andersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Backman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Dahlén
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Stegmayr
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rantapää-Dahlqvist, S., Neumann-Andersen, G., Backman, C. et al. Echocardiographic findings, lipids and lipoprotein(a) in patients with systemic lupus erythematosus. Clin Rheumatol 16, 140–148 (1997). https://doi.org/10.1007/BF02247842

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02247842

Key words

Search

Navigation