Coronary arterial disease in systemic lupus erythematosus: Quantification of degrees of narrowing in 22 necropsy patients (21 women) aged 16 to 37 years

doi:10.1016/0002-9343(81)90532-5

The American Journal of Medicine

Volume 70, Issue 4, April 1981, Pages 775-781

https://doi.org/10.1016/0002-9343(81)90532-5 Get rights and content

Abstract

The degrees of cross-sectional area luminal narrowing by atherosclerotic plaques of each 5 mm long segment of each of the four major (right, left main, left anterior descending and left circumflex) epicardial coronary arteries in 22 necropsy patients (age 16 to 37 years, 21 women) with systemic lupus erythematosus (SLE) was determined, and the findings were compared to those in 13 control subjects. Of 623 coronary segments (5 mm long) in the patients with SLE, 80 (13 percent) were narrowed 76 to 100 percent (controls = 0 of 431 segments); 125 (20 percent), 51 to 75 percent (controls = 6 percent); 273 (44 percent), 26 to 50 percent (controls = 63 percent) and 145 (23 percent), 0 to 25 percent (controls = 31 percent). Of the 22 patients with SLE, 10 had one or more of the four major coronary arteries narrowed 76 to 100 percent in cross-sectional area, and 12 patients had lesser degrees of narrowing similar to that in the 13 control subjects. The 10 patients with SLE and severe coronary narrowing compared to the 12 patients with SLE and no severe (> 75 percent) coronary narrowing had significantly higher (1) mean values of total serum cholesterol (382 versus 290 mg/dl), (2) mean systolic/diastolic systemic arterial pressures (175/119 versus 151/93 mm Hg), (3) frequencies of mitral valvular disease (seven of 10 patients versus none of 12 patients) and (4) frequencies of pericardial adhesions (seven of 10 patients versus three of 12 patients).

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Citation Excerpt :
Early coronary heart disease has appeared as a main cause of morbidity in SLE patients. In addition, cardiovascular induced mortality has been increased in these patients compared with the general population [2–6]. Increased cardiovascular events can be explained in part by an increased prevalence of cardiovascular disease (CVD) risk factors such as metabolic syndrome (MetS) and its components [6].
Descriptions of the body composition parameters and metabolism in systemic lupus erythematosus (SLE) patients are limited. The aim of the present work was to assess the body composition factors and basal metabolic rate (BMR) in Iranian SLE patients and to study its relation to disease activity.
Seventy-four female SLE patients and 76 matched controls were included in the present study. The body mass index (BMI), body fat (BF), visceral fat (VF), body muscle (BM) and basal metabolic rate (BMR) were measured using BIA (bioelectrical impedance analysis). The international physical activity questionnaire (IPAQ) was used to assess physical activity. SLE disease activity index (SLEDAI) was assessed for all the patients.
The mean age of the patients was 38.5 ± 10.1 years with a median disease duration of 7.5 years. The median SLEDAI was 4. Body composition factors (BMI, BF, VF, and BM) were not significantly different between the patients and their controls. The BMR in SLE patients was significantly lower (1328.4 ± 154.6 kcal/day) than the controls (1400.4 ± 200.4 kcal/day) (p = 0.01). No differences have been found in body composition parameters and BMR between the SLE patients with high and low SLEDAI or daily corticosteroid dose. There was no significant correlation between the SLEDAI and any of the studied parameters except for a negative association with age (r = −0.3, p = 0.03).
SLE women have a significantly lower BMR compared to their controls. No significant differences have been observed regarding BMI, BF, BM and VF between the groups.

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¹: From the Pathology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.

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Clinical studyCoronary arterial disease in systemic lupus erythematosus: Quantification of degrees of narrowing in 22 necropsy patients (21 women) aged 16 to 37 years

Abstract

Am J Med

Chest

A hitherto undescribed form of valvular and mural endocarditis

Arch Intern Med

A diffuse disease of the peripheral circulation (usually associated with lupus erythematosus and endocarditis)

Trans Assoc Am Physicians

Clinical study
Coronary arterial disease in systemic lupus erythematosus: Quantification of degrees of narrowing in 22 necropsy patients (21 women) aged 16 to 37 years