Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1996 Jul;55(7):450–454. doi: 10.1136/ard.55.7.450

Cardiac manifestations in primary Sjögren's syndrome.

M Gyöngyösi 1, G Pokorny 1, Z Jambrik 1, L Kovács 1, A Kovács 1, E Makula 1, M Csanády 1
PMCID: PMC1010208  PMID: 8774163

Abstract

OBJECTIVE: To determine cardiac manifestations in primary Sjögren's syndrome (SS). METHODS: Echocardiographic examination was undertaken in 64 patients (62 women, two men) with primary SS (54 definite (DSS) and 10 probable (PSS)) who had systemic symptoms. Twenty one healthy women volunteers of similar age acted as controls. RESULTS: Acute exudative pericarditis occurred in only one patient. An echogenic pericardium was demonstrated in 21 patients (19 DSS, two PSS) (33%) who had a previous symptom free pericarditis, but in none of the controls. Pulmonary pressure was significantly greater in the patients than in the controls (31 (SD 8) mm Hg compared with 24 (7) mm Hg), but there was no significant difference between the DSS and PSS groups. Left ventricular (LV) systolic function was similar in patients and controls. Twenty two patients (20 DSS, two PSS) and one control subject were excluded from LV diastolic function evaluation because of conditions likely to influence the parameters. Of the remaining 42 patients with SS (34 DSS, eight PSS), 21 (17 DSS, four PSS) had impaired diastolic function, confirmed by several diastolic parameters. LV diastolic dysfunction and echogenic pericardium occurred independently of each other, and there was no correlation between the occurrence of these silent cardiac abnormalities and the clinical and laboratory findings. CONCLUSIONS: Obvious cardiac involvement is rare in primary SS, but clinically silent manifestations (symptom free pericarditis and LV diastolic dysfunction) are common. The clinical and prognostic significance of these changes cannot yet be defined.

Full text

PDF
450

Images in this article

452Image
on p.452

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Buyon J. P., Winchester R. J., Slade S. G., Arnett F., Copel J., Friedman D., Lockshin M. D. Identification of mothers at risk for congenital heart block and other neonatal lupus syndromes in their children. Comparison of enzyme-linked immunosorbent assay and immunoblot for measurement of anti-SS-A/Ro and anti-SS-B/La antibodies. Arthritis Rheum. 1993 Sep;36(9):1263–1273. doi: 10.1002/art.1780360911. [DOI] [PubMed] [Google Scholar]
  2. Ellis W. W., Baer A. N., Robertson R. M., Pincus T., Kronenberg M. W. Left ventricular dysfunction induced by cold exposure in patients with systemic sclerosis. Am J Med. 1986 Mar;80(3):385–392. doi: 10.1016/0002-9343(86)90711-4. [DOI] [PubMed] [Google Scholar]
  3. Fox R. I. Vth International Symposium on Sjögren's syndrome. Clinical aspects and therapy. Clin Rheumatol. 1995 Jul;14 (Suppl 1):17–19. doi: 10.1007/BF03342633. [DOI] [PubMed] [Google Scholar]
  4. Fujimoto S., Kagoshima T., Nakajima T., Dohi K. Doppler echocardiographic assessment of left ventricular diastolic function in patients with progressive systemic sclerosis. Cardiology. 1993;83(4):217–227. doi: 10.1159/000175973. [DOI] [PubMed] [Google Scholar]
  5. Gustafsson R., Mannting F., Kazzam E., Waldenström A., Hällgren R. Cold-induced reversible myocardial ischaemia in systemic sclerosis. Lancet. 1989 Aug 26;2(8661):475–479. doi: 10.1016/s0140-6736(89)92088-6. [DOI] [PubMed] [Google Scholar]
  6. Julkunen H., Kurki P., Kaaja R., Heikkilä R., Immonen I., Chan E. K., Wallgren E., Friman C. Isolated congenital heart block. Long-term outcome of mothers and characterization of the immune response to SS-A/Ro and to SS-B/La. Arthritis Rheum. 1993 Nov;36(11):1588–1598. doi: 10.1002/art.1780361114. [DOI] [PubMed] [Google Scholar]
  7. Manthorpe R., Frost-Larsen K., Isager H., Prause J. U. Sjögren's syndrome. A review with emphasis on immunological features. Allergy. 1981 Apr;36(3):139–153. doi: 10.1111/j.1398-9995.1981.tb01829.x. [DOI] [PubMed] [Google Scholar]
  8. Manthorpe T., Manthorpe R. Congenital complete heart block in children of mothers with primary Sjögren's syndrome. Lancet. 1992 Nov 28;340(8831):1359–1360. doi: 10.1016/0140-6736(92)92549-u. [DOI] [PubMed] [Google Scholar]
  9. Moutsopoulos H. M., Chused T. M., Mann D. L., Klippel J. H., Fauci A. S., Frank M. M., Lawley T. J., Hamburger M. I. Sjögren's syndrome (Sicca syndrome): current issues. Ann Intern Med. 1980 Feb;92(2 Pt 1):212–226. doi: 10.7326/0003-4819-92-2-212. [DOI] [PubMed] [Google Scholar]
  10. Oxholm P., Asmussen K. Classification of disease manifestations in primary Sjögren's syndrome: present status and a new proposal. Clin Rheumatol. 1995 Jul;14 (Suppl 1):3–7. doi: 10.1007/BF03342630. [DOI] [PubMed] [Google Scholar]
  11. Pokorny G., Karácsony G., Lonovics J., Hudák J., Németh J., Varró V. Types of atrophic gastritis in patients with primary Sjögren's syndrome. Ann Rheum Dis. 1991 Feb;50(2):97–100. doi: 10.1136/ard.50.2.97. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Pokorny G., Németh J., Marczinovits I., Kiss M., Hudák J., Husz S. Primary Sjögren's syndrome from the viewpoint of an internal physician. Int Ophthalmol. 1991 Nov;15(6):401–406. doi: 10.1007/BF00137952. [DOI] [PubMed] [Google Scholar]
  13. Pokorny G., Sonkodi S., Iványi B., Mohácsi G., Csáti S., Iványi T., Ormos J. Renal involvement in patients with primary Sjögren's syndrome. Scand J Rheumatol. 1989;18(4):231–234. doi: 10.3109/03009748909099934. [DOI] [PubMed] [Google Scholar]
  14. Sahn D. J., DeMaria A., Kisslo J., Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978 Dec;58(6):1072–1083. doi: 10.1161/01.cir.58.6.1072. [DOI] [PubMed] [Google Scholar]
  15. Thomas J. D., Weyman A. E. Echocardiographic Doppler evaluation of left ventricular diastolic function. Physics and physiology. Circulation. 1991 Sep;84(3):977–990. doi: 10.1161/01.cir.84.3.977. [DOI] [PubMed] [Google Scholar]
  16. Vitali C., Bombardieri S., Moutsopoulos H. M., Balestrieri G., Bencivelli W., Bernstein R. M., Bjerrum K. B., Braga S., Coll J., de Vita S. Preliminary criteria for the classification of Sjögren's syndrome. Results of a prospective concerted action supported by the European Community. Arthritis Rheum. 1993 Mar;36(3):340–347. doi: 10.1002/art.1780360309. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES