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Cardiac involvement in systemic lupus erythematosus

Division of Rheumatology, University of Padua, Padua, Italy, adoria{at}unipd.it

L Iaccarino

Division of Rheumatology, University of Padua, Padua, Italy

P Sarzi-Puttini

Rheumatology Unit, L. Sacco University Hospital, Milan, Italy

F Atzeni

Rheumatology Unit, L. Sacco University Hospital, Milan, Italy

M Turriel

Department of Cardiology, Istituto Ortopedico Galeazzi, University of Milan, Milan, Italy

M Petri

Department of Medicine, The John Hopkins University School of Medicine, Baltimore, USA

Pericarditis is the most common cardiac abnormality in systemic lupus erythematosus (SLE) patients, but lesions of the valves, myocardium and coronary vessels may all occur. In the past, cardiac manifestations were severe and life threatening, often leading to death. Therefore, they were frequently found in post-mortem examinations. Nowadays cardiac manifestations are often mild and asymptomatic. However, they can be frequently recognized by echocardiography and other noninvasive tests. Echocardiography is a sensitive and specific technique in detecting cardiac abnormalities, particularly mild pericarditis, valvular lesions and myocardial dysfunction. Therefore, echocardiography should be performed periodically in SLE patients. Vascular occlusion, including coronary arteries, may develop due to vasculitis, premature atherosclerosis or antiphospholipid antibodies associated with SLE. Premature atherosclerosis is the most frequent cause of coronary artery disease (CAD) in SLE patients. Efforts should be made to control traditional risk factors as well as all other factors which could contribute to atherosclerotic plaque development.

Key Words: diagnosis • echocardiography • heart • pathogenesis • systemic lupus erythematosus • treatment

Lupus, Vol. 14, No. 9, 683-686 (2005)
DOI: 10.1191/0961203305lu2200oa


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