Systemic lupus erythematosus presenting with cardiac symptoms

Chen, Ping-Yuan; Chang, Ching-Hung; Hsu, Chien‐Chin; Liao, Yuan-Mei; Chen, Kuo-Tai

doi:10.1016/j.ajem.2014.06.036

Cited by 9 publications

(4 citation statements)

References 10 publications

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“…Continuous cardiomyo-cyte loss eventually damages the heart, progressively diminishes its functionality, and leads to HF ( 26 ). Cardiac diseases tend to be silent for long periods of time, but are potentially fatal in SLE ( 27 , 28 ).…”

Section: Discussionmentioning

confidence: 99%

Lupus Heart Disease Modeling with Combination of Induced Pluripotent Stem Cell-Derived Cardiomyocytes and Lupus Patient Serum

et al. 2021

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Background and Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease mainly affecting young women of childbearing age. SLE affects the skin, joints, muscles, kidneys, lungs, and heart. Cardiovascular complications are common causes of death in patients with SLE. However, the complexity of the cardiovascular system and the rarity of SLE make it difficult to investigate these morbidities. Patient-derived induced pluripotent stem cells (iPSCs) serve as a novel tool for drug screening and pathophysiological studies in the absence of patient samples. Methods and Results: We differentiated CMs from HC-and SLE-iPSCs using 2D culture platforms. SLE-CMs showed decreased proliferation and increased levels of fibrosis and hypertrophy marker expression; however, HC-and SLE-monolayer CMs reacted differently to SLE serum treatment. HC-iPSCs were also differentiated into CMs using 3D spheroid culture and anti-Ro autoantibody was treated along with SLE serum. 3D-HC-CMs generated more mature CMs compared to the CMs generated using 2D culture. The treatment of anti-Ro autoantibody rapidly increased the gene expression of fibrosis, hypertrophy, and apoptosis markers, and altered the calcium signaling in the CMs. Conclusions: iPSC derived cardiomyocytes with patient-derived serum, and anti-Ro antibody treatment could serve in effective autoimmune disease modeling including SLE. We believe that the present study might briefly provide possibilities on the application of a combination of patient-derived materials and iPSCs in disease modeling of autoimmune diseases.

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Section: Discussionmentioning

confidence: 99%

Lupus Heart Disease Modeling with Combination of Induced Pluripotent Stem Cell-Derived Cardiomyocytes and Lupus Patient Serum

et al. 2021

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“…The cardiac representation as initial manifestations in lupus is uncommon, and cardiac diseases tend to be clinically silent for long periods [13, 25]. Yet, the cardiac complications of lupus are potentially serious.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Manifestations in Systemic Lupus Erythematosus: Clinical Correlates of Subclinical Echocardiographic Features

Mohamed

Hammam

Zohri

et al. 2019

BioMed Research International

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Objectives This study aims to correlate subclinical echocardiographic features with the clinical, laboratory, and therapeutic profiles of the patients to characterize risks for systemic lupus erythematosus (SLE) cardiac diseases. Methods The study included 59 SLE patients. Demographic data, disease characteristics, and current therapies were recorded, and the anthropometric measurements and routine laboratory tests were performed. The disease activity by the SLE Disease Activity Index-2K (SLEDAI2K) and the presence of metabolic syndrome (MetS) were assessed. Two-dimensional echocardiography was performed. Results The mean age of the patients was 31.3 ± 10.5 years, and the disease duration was 5.18 ± 4.1 years. 86.4% of the patients were females. Cardiac presentations by echocardiography were mainly mitral regurgitation (33.9%), tricuspid regurgitation (32.2%), mitral thickening (18.6%), aortic thickening (13.6%), pericardial effusion (13.6%), and pulmonary hypertension (8.5%) in order of frequency. The frequency of different echocardiographic findings with respect to other clinical phenotypes showed peaks with renal disease, MetS, and leukopenia. Components of MetS (triglycerides, high systolic blood pressure) and avascular necrosis were significant predictors for pericardial diseases (OR=1.011 CI 95% 1-1.022, p=0.046, OR=1.157 CI 95% 1.025-1.307, p=0.018, and OR=74.78 CI 95% 2.52-2215.76, p=0.013, respectively), and it is likely that hydroxychloroquine was protective against them. Age of the patients was a significant predictor for tricuspid regurgitation (OR=1.063 CI 95% 1.004-1.126, p=0.036). Mucosal ulcers were negative predictors for mitral thickening and regurgitation (OR=0.2 CI 95% 0.059-0.673, p=0.009). The use of corticosteroids appeared to protect against a number of valve lesions especially tricuspid regurgitation (OR=0.299 CI 95% 0.088-1.019, p=0.054). Conclusion This study highlighted different echocardiographic features and identified clinical predictors of different cardiac pathologies aiming to determine patients at risk and improve the prognosis of SLE cardiac diseases.

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“…Cardiovascular events are proportionally higher in SLE compared to general populations of comparable age and sex [5] . Cardiac abnormalities are associated with positive anti double standard DNA in lupus cases [6] . The detailed pathologic mechanism of SLE is still controvertible.…”

Section: Introductionmentioning

confidence: 97%

Cardiac manifestations in cases with systemic lupus erythematosus: A prospective study

Chandulal¹,

Naik²

2021

Int. J. Adv. Res. Med.

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Cardiovascular complications are common cause of mortality on cases with systemic lupus erythematosus (SLE). Both idiopathic and drug induced lupus have cardiac manifestations. The present study was designed to evaluate cardiovascular manifestations in cases with systemic lupus erythematosus. A total of 64 clinically and serologically diagnosed cases of systemic lupus erythematosus above 21 years of age were recruited. Clinical and serological examination was performed to assess the study participants. All the cases were subjected to ECG and chest X-ray and later were subjected to echocardiography to assess all the cardiac features. Majority cases were in between 21-30 years (32.1%) followed by 31-40 years (28.1%). 54.68% cases had disease >5 years and 45.31% cases had disease <5 years. 46.87% cases had oral and nasal ulcers, followed by chest pain (37.5%), dyspnoea (31.25%), photosensitivity (17.1%), Raynaud phenomenon (17.1%), arthralgia (15.6%), palpitations (15.6%), seizures (12.5%), syncope (10.9%) and myalgia (7.81%). Echo findings showed that 6 cases had systolic dysfunction, 4 cases had diastolic dysfunction, 7 cases had regional hypokinesia, 6 cases had global hypokinesia, 22 cases had pericardial effusion, 4 cases had pericardial thickening, 10 cases had mitral valve prolapse syndrome, 1 case had mitral stenosis, 16 cases had mitral regurgitation, 9 cases had aortic thickening, 6 cases had aortic regurgitation, 10 cases had tricuspid regurgitation, 11 cases had pulmonary hypertension and 1 case had pulmonary stenosis. Pericarditis and pericardial effusion was the most common cardiovascular manifestation and global hypokinesia was least common cardiac manifestation.

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Systemic lupus erythematosus presenting with cardiac symptoms

Cited by 9 publications

References 10 publications

Lupus Heart Disease Modeling with Combination of Induced Pluripotent Stem Cell-Derived Cardiomyocytes and Lupus Patient Serum

Lupus Heart Disease Modeling with Combination of Induced Pluripotent Stem Cell-Derived Cardiomyocytes and Lupus Patient Serum

Cardiac Manifestations in Systemic Lupus Erythematosus: Clinical Correlates of Subclinical Echocardiographic Features

Cardiac manifestations in cases with systemic lupus erythematosus: A prospective study

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