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Titolo:
Glucocorticoid effects on myocardial performance in patients with systemicsclerosis
Autore:
Antoniades, L; Sfikakis, PP; Mavrikakis, M;
Indirizzi:
Univ Athens, Sch Med, Alexandra Hosp, Dept Therapeut, GR-11527 Athens, Greece Univ Athens Athens Greece GR-11527 pt Therapeut, GR-11527 Athens, Greece Univ Athens, Sch Med, Laikon Hosp, Dept Propedeut Med 1, GR-11527 Athens, Greece Univ Athens Athens Greece GR-11527 pedeut Med 1, GR-11527 Athens, Greece
Titolo Testata:
CLINICAL AND EXPERIMENTAL RHEUMATOLOGY
fascicolo: 4, volume: 19, anno: 2001,
pagine: 431 - 437
SICI:
0392-856X(200107/08)19:4<431:GEOMPI>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIAC DYSFUNCTION; LUPUS-ERYTHEMATOSUS; SCLERODERMA; PERFUSION; ABNORMALITIES; INVOLVEMENT; NIFEDIPINE; DISEASE;
Keywords:
prednisolone; systemic sclerosis; radionuclide ventriculography; ejection fraction; cardiac involvement; systemic lupus erythematosus; rheumatoid arthritis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Sfikakis, PP Amaryllidos Str 3, Athens 15452, Greece Amaryllidos Str 3 Athens Greece 15452 Athens 15452, Greece
Citazione:
L. Antoniades et al., "Glucocorticoid effects on myocardial performance in patients with systemicsclerosis", CLIN EXP RH, 19(4), 2001, pp. 431-437

Abstract

Objective Myocardial inflammation and fibrosis are common autopsy findingsin systemic sclerosis (SSc) and, although symptomatic cardiac involvement occurs less often, current therapies remain empiric and do not prevent or modify, its course. In this open, uncontrolled study we assessed the short-term effects of glucocorticoid administration on myocardial performance in patients with SSc in the absence of clinically overt cardiac disease. Methods Resting radionuclide ventriculography with Tc-99m was performed before and 20 days after the administration of prednisolone, 20 mg daily, in 32 patients with SSc without clinically evident myocardial dysfunction at rest; 13 and 19 patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), respectively, were studied in parallel as controls. Results The mean left ventricular ejection fraction (LVEF) value at baseline was 59% in the SSc group; similar values were found for the SLE (61%) and RA (59%) groups. An impaired LVEF (i.e., < 50%) was found in 6 patients with SSc and in 1 patient with SLE. Prednisolone administration resulted in a significant percent improvement in the baseline LVEF (mean 18%, p = 0.0001) in the SSc group; this improvement was greater in the patients with diffuse SSc than in those with limited skin disease (27% vs 10%, p = 0.02). Theimprovement was most prominent in the 6 patients with an initial impaired LVEF: No significant improvement was observed in the SLE or RA control groups. The linear trend between the individual baseline LVEF values in patients with SSc and their percent changes after treatment (r(2) = 0.55 p: 0.00001) showed that the lower the initial LVEF the greater the improvement caused by prednisolone. The degree of LVEF improvement was also associated with the individual erythrocyte sedimentation rate values and serum IgG concentrations at baseline. Prednisolone-induced changes in LVEF were not associated with any changes in blood pressure, heart rate, blood, plasma, or red cell volumes. Conclusion Glucocorticoid administration may improve myocardial performance in some patients with SSc. Although further double-blind controlled studies of the long-term effects are warranted, such treatment may be useful in those patients with SSc and documented low LVEF: if they are kept under careful observation for objective improvement.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/21 alle ore 11:31:54