الفهرس 
Patiens and methodsOnly 14 pages are availabe for public view
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Abstract
SUMMARY AND CONCLUSION
SUMMARY
Connective tissue diseases are a group of chronic
inflammatory disorders, they involve many different organs
and therefore exhibit a wide spectrum of clinical
manifestations. Their aetiology is unknown but it is generally
thought to be multi factorial, involving immunological, genetic
and environmental, possibly viral, factors.
The heart is one of the target organs affected in connective
tissue diseases. Cardiac lesions have been documented to
occur in subclinical forms in many cases of theses diseases.
Echocardiography being a recent sensitive tool, would increase
the awareness of many of these sub clinical lesions.
The aim of this work is to record the incidence of cardiac
lesions In connective tissue diseases in addition, the
correlation between cardiac lesion and various clincolaboratory
parameters of these disorders were considered.
Sixty six patients (30 RA, 20 SLE, 6 scleroderma, and 4
dermatomyositis) who were attending Benha University
hospital were included In the present work. full clinical
examination laboratory investigation, radiological
investigation and echocardiography was performed to all
patients. The results were tabulated, graphed and statistically
analyzed.
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SUMMARYAND CO ’LUSION
was 9.5
The result in Group I (Adult onset RA).
Sixteen patients were included, females were 14 (87.5 0) while
males were 2 (12.5 %) with female to male ratio 7: 1.
The median age of examined cases was 49.5 yea with a
range from 20 to 60 years.
The median duration of disease in examined
years with a range between 3 and 20 years.
The median of disease activity was 2.8 with a rang from 0.2
to 3.8, most of patients 45% fall into a grade 3 cl sification
and little 5% fall into grade 4 classification.
The incidence of cardiac lesions was 62.5% of cases.
The commonest valve to be affected was mitral Ive 50%
there was significant correlation between echo car 0 graphic
finding, pain scale (p = 0.05) and functional capacity
(p=0.003).
There was non significant relationship between the presence of
cardiac lesions and disease (p= 0.3) duration ~ld disease
activity index (p= 0.9). i
There was non significant relation between echocardiographic
finding and other clinical or laboratory parameters.
As regards group II (Juvenile rheumatoid arthritis cases)
Fourteen children were include who were 4 females and 10
males with male to female ratio I: 2.5.
!
Their ages were between 3 and 18 years with a imedian 10
i
years.
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SUMMARY AND CO 7LUSION
Disease durations were between 0.2 -8 years with a
2.5 years.
The cardiac lesions were found in 50% of case.
The commonest lesion was pericardiallesion 28%.
There were significant correlations between echocard ograplic
finding, age (p= 0.04), disease duration (p= 0.02 and pain
score (p = 0.03).
There were non significant correlation between
echocardiographic finding and disease activity index (p = 0.2),
articular index (p= 0.3), ESR (p = 0.7), or Hb (p = o.d,).
As regards group III(SLE patients).
Twenty cases were included who were 19 females (~15%)and
one male (5%) with male to female ratio 1-18.
Their ages were between 18 and 40 years with a median of
27.5 years.
Disease activity index (SLE DAI) was between 5~45with a
median of20.
Most of patient were of moderate grade 50% and little of them
were of severe grade 20%.
The cardiac lesions were found in 80% of cases.
_ The commonest lesion was miltral valve thickness (4Q%),mitral
regurge 10%,AR 20%, LVH 10% and pericardial Iesion 20 %.
I
SUMMARY AND C0tjCLUSION
_ There was significant correlation between echocardiographic
findings, age (p = 0.006), disease duration (p= 0.007) and pain
score.
-There was insignificant correlation between echocardiographic
findings and disease activity index (p = 0.6), ESR P= 0.4) or
Hb (p= 0.4).
As regards group IV (scleroderma group).
Six cases was include they were females.
Their ages were between 0.5 and 10 years with a median of 4
years.
Five cases were with proximal sclerosis and one case was with
only distal sclerosis.
The cardiac lesions were found m 83% of cases.
-The commonest lesions were pulmonary hyper tension 67% and
right ventricular filling defect 67%.
-There was significant correlation between echocardiographic
findings, age (p= 0.01) and disease duration (p=0.05).
-There was non significant correlation between
echocardiographic findings, ESR (p = 0.2) or Hb (p =0.7).
As regards Group V idiopathic inflammatory muscle disease.
Four cases of dermatomyositis were include who were
females.
Their ages were between 18 and 40 years with .median of
29.5 years.
There was no abnormal echocardiographic findi gs found in
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our cases.
SUMMARY ’iN» C04VCLUSION
CONCLUSION AND RECOMMENDATION
_ Cardiac involvement in connective tissue diseases is frequently
present.
_ Echocardiography enable the early detection of cardiovascular
dysfunction in connective tissue diseases even III
asymptomatic cases.
_ The incidence of cardiovascular lesions increases with age and
duration of diseases.
_ There are no fixed parameters which predict the cardiac
affections.
_ Cardiovascular complications are major factors in mortality of
connective tissue diseases so we recommend a ro nine follow
up by echocardiography for all cases of conne ctive tissue
diseases.