[Cardiac anomalies in systemic lupus erythematosus: their prevalence and relation to duration, disease activity and the presence of antiphospholipid antibodies]. / Anomalie cardiache nel lupus eritematosus sistemico: prevalenza e relazione con durata, attività della malattia e presenza di anticorpi antifosfolipidi.

We conducted an echocardiographic study to determine the incidence and spectrum of morphologic and functional cardiac abnormalities in systemic lupus erythematosus (SLE) and to relate these findings to the disease activity and duration, and the presence of antiphospholipid (APL) antibodies. Thirty consecutive patients with LES (5 male and 25 female, mean age 37 +/- 11 years) were studied with a clinical cardiovascular examination and M-mode, 2-D Doppler echocardiogram. All patients fulfilled the American Rheumatism Association criteria for diagnosis of SLE. Disease activity was scored using the "Lupus Activity Criteria Count". The duration of the disease was less than 1 year in 5 patients (16.7%), between 1 and 5 years in 7 (23.3%), and superior to 5 years in 18 (60%). No patient had a history of rheumatic fever or infective endocarditis. All patients had received steroid therapy. In 26.7% of patients the disease was active, and in 33.3% APL antibodies were present. Patients were matched by number, age and sex with the control group. In 73.3% of the patients the echocardiogram resulted abnormal; valvular disease occurred in 30% and the echocardiographic features were of diffuse thickening, with 4 mitral and 2 aortic regurgitations. No valvular dysfunctions were significant, nor was Libman-Sacks endocarditis present. Pericardial disease, effusion or thickening was detected in 33.3% of the echocardiograms. Furthermore, there was one patient with left ventricular mild hypertrophy; 2 with a mild enlargement of the left ventricle with no segmental abnormalities of wall motion and no systolic disfunction; 8 patients (26.7%) were normal. Compared with the control group, patients with SLE had an increased prevalence of echocardiographic abnormalities, especially pericardial (p < 0.001) and valvular (p < 0.01). No association was found between activity, duration of the disease and prevalence of cardiac abnormalities. On the contrary, an association between the presence of APL antibodies and cardiac abnormalities at the echocardiographic examination was evident (p < 0.05).

[Prevention of paroxysmal atrial fibrillation with propafenone after withdrawal of amiodarone because of side effects]. / Profilassi della fibrillazione atriale parossistica con propafenone dopo sospensione di amiodarone per effetti collaterali.

The authors evaluated the efficacy of medium term prophylaxis of atrial fibrillation (AF) with propafenon (P) in 33 symptomatic patients. Consecutive patients were treated with P replacing previous therapy with amiodarone (A) withdrawn on account of adverse side effects occurring on average after 1.8 years' treatment. Quantification of AF episodes was based on symptoms reported by patients, ECG, and dynamic Holter-ECG performed every 3-6 months. During A treatment (average daily dosage 216 mg) 32% of patients had reported more than two episodes of AF, 52% one or two episodes, and 16 none during the last 6 months. During 6 months of P treatment (average daily dosage 586 mg) 28% had more than two episodes, 64% had one or two, and 8% had none. The difference of incidence of AF episodes between the two treatments was not statistically significant. Side effects requiring withdrawal of the drug were not observed with P. The results obtained confirm P as a valid therapeutic resource for treatment of recurrent paroxysmall AF. In addition, the drug was also well tolerated during medium term application.

[Alpha-interferon therapy: an echographic study of left ventricular function and a clinical assessment of cardiovascular complications]. / Terapia con alfa interferone: studio ecocardiografico della funzione ventricolare sinistra e valutazione clinica delle complicanze cardiovascolari.

Many side-effects of alpha interferon (alpha-I) therapy have occurred as a result of its widespread clinical applications. The hypothesis of alpha-I related cardiomyopathy is particularly interesting. Our study involved echocardiographic evaluation of left ventricular function and cardiovascular complications in 35 patients with chronic hepatitis treated with alpha-I at 20 MU/week for an average of 10.8 months. The results were compared with those of a control group. Of the values studied, only Max E V and the E/A ratio were statistically significant. No cardiovascular side-effects were found.