Raynaud's phenomenon is correlated with elevated systolic pulmonary arterial pressure in patients with systemic lupus erythematosus

Kasparian, A.; Floros, A; Gialafos, Elias; Kanakis, Meletios; Tassiopoulos, Stergios; Kafasi, Nikolitsa; Vaiopoulos, George

doi:10.1177/0961203307080629

Cited by 49 publications

(34 citation statements)

References 14 publications

(14 reference statements)

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“…Our data conWrmed the results of previous studies showing Raynaud's phenomenon had positive correlation with PAH in autoimmune diseases [20][21][22]. Raynaud's phenomenon is characterized by vasospasm [23], which could be the cutaneous manifestation of general vascular disorder also resulting in pulmonary arterial vasoconstriction [24].…”

Section: Discussionsupporting

confidence: 94%

Clinical features and independent predictors of pulmonary arterial hypertension in systemic lupus erythematosus

et al. 2011

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Pulmonary arterial hypertension (PAH) is a devastating complication of systemic lupus erythematosus (SLE). We aim to estimate the putative predictors contributing to early identification of PAH, thus improve appropriate medical intervention and a better prognosis. A retrospective case-control study was conducted. Forty-one SLE patients with PAH and 106 SLE patients without PAH were enrolled. Demographic variables, clinical features, and laboratory data were compared between the two groups. Univariate and multivariate logistic regression models were used to examine the predictors contributing to PAH in SLE. Serositis, Raynaud's phenomenon, high disease activity, anticardiolipin antibodies, and anti-U1RNP were significantly associated with SLE-PAH. Univariate and multivariate analysis showed that Raynaud's phenomenon, anticardiolipin antibodies, and anti-U1RNP were independent predictors of PAH in SLE. This study highlighted the clinical pattern of SLE-PAH patients, and underlined the leading predictors of PAH development among patients with SLE. Routine echocardiography is recommended in SLE patients with the independent predictors mentioned above.

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Section: Discussionsupporting

confidence: 94%

Clinical features and independent predictors of pulmonary arterial hypertension in systemic lupus erythematosus

et al. 2011

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“…Anti-RNP antibody and Raynaud's phenomenon (RP) were believed to be associated with this subtype, 14,19,34,42 and RP was also proved as an indicator of disease severity. 36,38,42–44 Percentage of RP in our study was 64.5%, in accordance with previous published data; 45 however, we lack the data of the control group. Thus we could not prove it as a risk factor.…”

Section: Discussionsupporting

confidence: 91%

Baseline Characteristics and Risk Factors of Pulmonary Arterial Hypertension in Systemic Lupus Erythematosus Patients

Huang

Liu

et al. 2016

Medicine

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Peking Union Medical College Hospital (PUMCH) has started a single-center right heart catheterization (RHC)-based pulmonary arterial hypertension (PAH) study in systemic lupus erythematosus (SLE) since 2006. The baseline characteristics of these patients were described and the risk factor for PAH in lupus was identified.The demographic, clinical, laboratory, and treatment characteristics of SLE patients with PAH when they were registered were collected as the baseline data. A case-control study was conducted by taking the admitted SLE-non-PAH patients adjusted for age and gender in a 4:1 ratio during the same period as the controls. The associated variables were examined by binary multivariate logistic regression analysis to identify possible risk factors. A total of 111 RHC-confirmed SLE-PAH patients were enrolled, with the onset age of 34.6 ± 8.6 years old and the average SLE duration of 5 years. RHC revealed mPAP as 46.4 ± 11.4 mm Hg, CI as 2.7 ± 0.8 L/min × m2, and PVR as 10.5 ± 4.8 WU. 46% of patients were WHO Fc I–II. All patients were treated with immunosuppressive agents and 65% patients had PAH-targeted therapy. The case-control study had confirmed 2 independent risk factors previously published: pericardial effusion (OR = 21.290, P < 0.001) and anti-RNP antibody (OR = 12.399, P < 0.001). Meanwhile, 6 independent variables were discovered: baseline SLE duration (OR = 1.118, P = 0.007), interstitial lung disease (OR = 17.027, P < 0.001=, without acute rash (OR = 3.258, P = 0.019), anti-SSA antibody (OR = 4.836, P = 0.004), SLEDAI≤9 (OR = 26.426, P < 0.001), ESR≤20 mm/h (OR = 12.068, P < 0.001), and uric acid > 357 μmol/L (OR = 9.666, P < 0.001) to be associated with PAH in SLE patients.The PUMCH study has shown that SLE patients complicated with PAH are usually earlier diagnosed and have less disease severity than patients without PAH. The immunosuppressive therapy rate and the PAH target therapy rate were high, which is consistent with reports from Western countries. This study has confirmed that pericardial effusion and positive anti-RNP antibody are risk factors for SLE-associated PAH. Long SLE disease duration, the presence of interstitial lung disease, without acute skin rash, positive anti-SSA antibody, low SLEDAI and ESR, and high uric acid levels are also associated with PAH in SLE patients.

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“…In SLE patients, RP is frequently present and it is associated with pulmonary hypertension (10). Long disease duration, RP and elevated serum CRP were independent predictive factors for SLE to develop digital gangrene (11).…”

Section: Discussionmentioning

confidence: 99%

Digital Ulcers as an Initial Manifestation of Systemic Lupus Erythematosus

et al. 2011

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Digital ulcers (DUs) and gangrene are common skin manifestations of connective tissue diseases, especially systemic sclerosis. Raynaud's phenomenon (RP) is an almost universal manifestation of systemic sclerosis, with 95% of all patients being affected, and resulting in DUs in approximately 30% of the patients each year. Although RP may be present in approximately 25-50% of the patients, DUs are relatively rare in systemic lupus erythematosus (SLE) and never present as an initial manifestation of disease. In this case report DUs appear as the initial manifestation of SLE in a young woman with a capillaroscopic scleroderma pattern and elevated systolic pulmonary arterial pressure.

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Raynaud's phenomenon is correlated with elevated systolic pulmonary arterial pressure in patients with systemic lupus erythematosus

Cited by 49 publications

References 14 publications

Clinical features and independent predictors of pulmonary arterial hypertension in systemic lupus erythematosus

Clinical features and independent predictors of pulmonary arterial hypertension in systemic lupus erythematosus

Baseline Characteristics and Risk Factors of Pulmonary Arterial Hypertension in Systemic Lupus Erythematosus Patients

Digital Ulcers as an Initial Manifestation of Systemic Lupus Erythematosus

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