Echocardiographic Findings in Systemic Lupus Erythematosus

BACKGROUND: Systemic lupus erythematosus(SLE) frequently has cardiovascular complications. Pericardial inflammation and effusion. ventricular dysfunction, valvular disease and coronary atherosclerosis may result in morbidity. While the pathologic findings in SLE have been well described, the antemortem documentation of the cardiac complications has been less frequent than the postmortem findings would support, we therefore sought to study how echocariography may improve the clinical assessment of cardiac involvement in 40 consecutive patients with SLE. SUBJECTS AND METHODS: This study began in 1990 with a prospective design. An appointment was scheduled with all patients whose SLE was diagnosed at the outpatient clinic and during the admission of the internal medicine service at the Kang Nam St Mary's hospital These were 40 female patients, with a mean age of 32+/-11 years(+/-SD). The average duration of disease was 37+/-32months, the average dosage of prednisolone per day was 20+/-17mg. M-mode and 2-D echocardiogram were carried out to the 40 SLE patients. RESULT: Seventeen(43%) of the SLE patients had pericardial effusion. Reduced left ventricular contractility was evident in 8 patients(20%). Abnormality of diastolic dysfunction to be checked by A/E ratio was in 3 patients(8%). No patients had echocardiographic evidence of pulmonary arterial hypertension. Clinical findings of myocardial dysfunction in these patients included dyspnea(30%), jugular venous distension(20%), rales(10%) and S3 gallop(8%). Valvular abnormality of SLE patients included mitral regurgitation in five patients(13%) and aortic regurgitation in two patients(5%). Electrocardiogram showed myocardial ischemia, atrial fibrillation and sick sinus syndrome in 3, 1 and 1 patients respectively. CONCLUSION: In this study, pericardial effusion were the most common echocardiopraphic abnormalities in Patients with SLE. The incidence of valvular and myocardial disease were relatively common.

Echocardiographic Changes in Cardiac Morphology and Function in Renal Transplant Recipients

BACKGROUND: Left ventricular hypertrophy is common in chronic renal failure patients and may contribute increased risk of cardiovascular morbidity and mortality. We evaluated the left ventricular morphology and function in renal transplant recipients to find the relationship between hemodynamic changes and morphologic and functional improvement after transplantation. METHODS: Serial echocardiographic evaluations were performed in 27 adults(20 men and 7 women) at the time of transplantaion and posttransplantation 1 month and 4 months. The average duration of hemodialysis was 16+/-24 months(mean+/-S.D.). RESULTS: At the time of transplantation, the hematocrit level was 21+/-6% and posttransplantation 1 month and 4 months, that was increased to 39+/-5% and 42+/-7%, respectively(p<0.001). Left ventricular mass index by echocardiography was decreased significantly from 246+/-87g/m2(pre-KT) to 169+/-38g/m2(post-KT 1 month) and 153+/-40g/m2(post-KT 4 months), respectively (p<0.001). Interventricular septal thickness and left ventricular posterior wall thickness were decreased significantly after 4 months of transplantation. Left ventricular systolic and diastolic dimensions were also decreased significantly after 1 month and 4 months of transplantation. Left ventricular volumes and cardiac output were also decreased significantly. But A/E ratio, ejection fraction and fractional shortening did not change significantly. CONCLUSION: These findings showed that pretransplant high output state was resolved radipidly(within 1 month) but the diastolic function did not improved after transplantation 1 month and 4 months.