Single photon emission computed tomography of technetium-99m tetrofosmin myocardial perfusion imaging in patients with systemic lupus erythematosus

Was to evaluate the utility of single-photon emission computed tomography [SPECT] of technetium-99m tetrofosmin [Tc-99m TF] myocardial perfusion imaging to detect myocardial involvement in patients with systemic lupus erythematosus [SLE] and its relation to presence or absence of cardiolipin antibodies [aCL]. Three groups of subjects-group 1: 33 SLE female patients with non-specific cardiac symptoms and signs, group 2: 28 female SLE patients without any cardiac symptoms and signs, and group 3: 24 female healthy controls-were evaluated by comparing rest and dipyridamole-stress Tc-99m TF myocardial perfusion SPECT. Cardiolipin antibodies had been assessed in all cases. Tc-99m TF myocardial perfusion SPECT revealed perfusion defects in 82% and 43% of the cases in groups 1 and 2, respectively. However, no cases in group 3 demonstrated myocardial perfusion defects. Multivariate analysis revealed a positive correlation between age and the number of CAD risk factors [r[2]=0.482]. Also, lower HDL, higher incidence of smoking, higher body mass index and postmenopausal status are an important determinant factors for presence of CAD in SLE patients. However, there is statistically higher prevalence of reversible perfusion defects [RDs] in group 2 with [+] aCL [31%] compared to [-] aCL [13.3%] in the same group. Also, RDs were statistically higher in [-] aCL of group 1 [61.1%] compared to [-] aCL in group 2. Tc-99m TF myocardial perfusion SPECT is a useful noninvasive imaging modality to detect cardiac involvement in SLE patients with or without cardiac symptoms and signs. Lower HDL cholesterol level, age and postmenopausal status in addition to higher body mass index were the variables associated with myocardial perfusion abnormalities in our patients

Smoking as a risk factor for renal impairment and proteinuria: a case control study

In this study, the aim is to examine the association between current smoking status and indicators of kidney affection shown by reduced GFR and elevated urine protein/creatinine ratio in a population free of hypertension and diabetes mellitus, The study was carried out on 190 subjects [90 smokers and 100 non smokers]. Both smokers and non smokers were not diabetics nor hypertensives. For each subject serum creatinine [an indicator of GFR] and protein/creatinine ratio in urine [an indicator of proteinuria] were determined. Smokers were classified according to smoking index, which equals number of cigarettes smoked per day multiplied by the number of years of smoking, into: mild smokers [smoking index <200], moderate smokers [smoking index 200-600] and heavy smokers [smoking index >600]. In our study, the socio-demographic characteristic of the study population were matched and there was no statistically significant difference between smokers and non smokers as regards residence, education, occupation and marital status. Males represent 95.6% and females represent 4.4% of the smokers while males represent 97% and females represent 3% of the non smokers. Smokers were more likely to have higher diastolic blood pressure and serum creatinine and lower GFR. In spite of the limited number of the study sample results pointed to the negative effect of smoking on kidney. There was a relation between smoking and renal impairment. A dose-response effect on GFR was shown with lifetime exposure to smoking. The relation between smoking and proteitnuria was less significant. However, one of the few females, who shared our study and was mild smoker, had been with proteinuria. This gives some relation between smoking and proteinuria especially in females. However. longitudinal studies with clear identification of abnormal glucose metabolism and hypertension will be required to provide the missing evidence for causality. The fact that smoking is an important renal risk factor trust be taken into consideration in the management of patients with renal disease. A concerted effort to encourage renal patients to give up smoking. Effective programs aimed at stroking prevention and cessation are highly needed