Assessment of myocardial perfusion and function in childhood systemic lupus erythematosus

被引:51
作者
Gazarian, M
Feldman, BM
Benson, LN
Gilday, DL
Laxer, RM
Silverman, ED
机构
[1] Univ Toronto, Hosp Sick Children, Dept Pediat, Div Rheumatol, Toronto, ON M5G 1X8, Canada
[2] Univ Toronto, Hosp Sick Children, Dept Pediat, Div Cardiol, Toronto, ON M5G 1X8, Canada
[3] Univ Toronto, Hosp Sick Children, Dept Diagnost Imaging, Toronto, ON M5G 1X8, Canada
[4] Univ Toronto, Hosp Sick Children, Dept Med, Toronto, ON M5G 1X8, Canada
[5] Univ Toronto, Hosp Sick Children, Dept Immunol, Toronto, ON M5G 1X8, Canada
关键词
D O I
10.1016/S0022-3476(98)70494-9
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objectives: To determine the prevalence of abnormalities in myocardial perfusion or function in children with systemic lupus erythematosus (SLE), and describe potential factors that may predict their development. Study design: Patients (n = 40; 30 female) were enrolled through the Lupus Clinic at The Hospital for Sick Children between 1990 and 1992. Resting and exercise thallium myocardial perfusion scans, radionuclide angiography with multiple gated acquisition (MUGA), and resting M-mode and two-dimensional echocardiography were performed. Results: All patients were free of symptoms, and none bad a history of ischemic heart disease. Their median age was 15.9 years (range 10.5 to 19.8 years) at enrollment. Abnormalities of coronary perfusion were found in 5 (16%) of 31 patients (95% confidence interval: 3%, 29%) and included a large fixed perfusion defect in 1; 5 of 27 MUGA scans showed marginally low left ventricular ejection fractions at rest, whereas all had normal exercise responses. In the group with abnormal thallium scans, three of five patients had antiphospholipid antibodies detected, and two of four had an abnormal plasma lipid profile. This group tended to have a shorter disease duration and had received a lower cumulative dose of corticosteroids; these differences were not statistically significant compared with the group with normal scans. Conclusion: Asymptomatic abnormalities of myocardial perfusion occur in children with SLE and are more common than previously suspected. Patients with these abnormalities of myocardial perfusion may be predisposed to the previously recognized early-onset ischemic heart disease seen in adults with SLE.
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页码:109 / 116
页数:8
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