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Echocardiographic Findings in Patients With Wegener Granulomatosis

2005; Elsevier BV; Volume: 80; Issue: 11 Linguagem: Inglês

10.4065/80.11.1435

1942-5546

Guilherme H. Oliveira, James B. Seward, Teresa S.M. Tsang, Ulrich Specks,

Pulmonary Hypertension Research and Treatments

OBJECTIVE To describe the spectrum and clinical implications of echocardiographic findings associated with Wegener granulomatosis. PATIENTS AND METHODS We retrospectively reviewed the clinical records and echocardiographic data of consecutive patients with confirmed Wegener granulomatosis referred to the echocardiography laboratory during the 21-year period from 1976 through 1997. RESULTS Of the 85 patients identified as having confirmed Wegener granulomatosis, 73 (86%) were found to have echocardiographic abnormalities. In 26 (36%) of these 73 patients, lesions appeared directly related to Wegener granulomatosis. We found regional wall motion abnormalities in 17 (65%) of these 26 patients. Left ventricular systolic dysfunction with decreased ejection fraction was found in 13 patients (50%) and pericardial effusion in 5 patients (19%). Other findings included valvulitis, left ventricular aneurysm, and a large intracardiac mass. A significantly increased mortality rate was observed among patients who had cardiac involvement of Wegener granulomatosis found by echocardiography. CONCLUSIONS We found a high frequency of echocardiographic abnormalities that appear to be related to Wegener granulomatosis and associated with increased mortality. Because cardiac involvement in Wegener granulomatosis often is silent and associated with increased morbidity and worse prognosis, echocardiographic screening of patients with active Wegener granulomatosis may be of clinical value. To describe the spectrum and clinical implications of echocardiographic findings associated with Wegener granulomatosis. We retrospectively reviewed the clinical records and echocardiographic data of consecutive patients with confirmed Wegener granulomatosis referred to the echocardiography laboratory during the 21-year period from 1976 through 1997. Of the 85 patients identified as having confirmed Wegener granulomatosis, 73 (86%) were found to have echocardiographic abnormalities. In 26 (36%) of these 73 patients, lesions appeared directly related to Wegener granulomatosis. We found regional wall motion abnormalities in 17 (65%) of these 26 patients. Left ventricular systolic dysfunction with decreased ejection fraction was found in 13 patients (50%) and pericardial effusion in 5 patients (19%). Other findings included valvulitis, left ventricular aneurysm, and a large intracardiac mass. A significantly increased mortality rate was observed among patients who had cardiac involvement of Wegener granulomatosis found by echocardiography. We found a high frequency of echocardiographic abnormalities that appear to be related to Wegener granulomatosis and associated with increased mortality. Because cardiac involvement in Wegener granulomatosis often is silent and associated with increased morbidity and worse prognosis, echocardiographic screening of patients with active Wegener granulomatosis may be of clinical value.