Blood serum levels of amino-terminal pro-C-type natriuretic peptide in patients with systemic sclerosis.

The aim of this pilot study was to examine the association of serum levels of amino-terminal fragment of pro-C-type natriuretic peptide (NT-proCNP), as a substitute measure of serum C-type natriuretic peptide (CNP), with clinical and laboratory findings in patients with systemic sclerosis (SSc). Serum NT-proCNP, soluble (s)E-and sP-selectin levels were examined using specific enzyme-linked immunosorbent assay in 30 patients with SSc and 30 healthy controls. We found no statistically significant difference in serum levels of NT-proCNP neither between patients with SSc and healthy controls nor between those treated with immunosuppressive agents and untreated patients. Nevertheless, in the investigated SSc group, serum NT-proCNP levels correlated with the concentrations of C-reactive protein (CRP) and the duration of the disease. Both sP- and sE-selectin levels were elevated in SSc patients when compared to healthy subjects. Also they did not correlate with the concentrations of NT-proCNP. The results of the study indicate that serum NT-proCNP level is likely secondary to existing inflammation. However, the magnitude of CNP action in SSc and its possible role in the pathogenesis of the disease remains to be elucidated.

Cardiac valvular disease in patients with systemic lupus erythematosus. Relationship with anticardiolipin antibodies.

We performed two-dimensional and Doppler echocardiography in 52 patients with systemic lupus erythematosus and in 34 healthy controls. In 25 patients (48.1%) echocardiographic disturbances were found (25/52 vs 2/34, p<0.001). Valvular abnormalities were detected in 18 patients (34.6%) but in only two controls (18/52 vs 2/34, p<0.01). The mitral valve was involved in 12 patients (23.1%). The most frequent finding was mild (13.5%) and moderate (9.6%) regurgitation or valvular thickening (9.6%). The aortic valve was involved in six and the tricuspid valve in three patients (11.5% and 5.8%, respectively). Only one patient had echocardiographic non-infective verrucous vegetation affecting the tricuspid valve. We did not observe significant hemodynamic valve disease. Endocardial findings were related to disease duration (p<0.05) but not to disease activity. Twenty-eight SLE patients (53.8%) had increased anticardiolipin antibodies (aCL). Patients with aCL (particularly those with IgG class) were characterized by a high incidence of echocardiographic abnormalities (p<0.001), mainly valvular (mitral or aortic) regurgitation (p<0.05). We found a relationship between anticardiolipin antibodies and disease activity (p<0.05). In conclusion, we postulate a prominent role for anticardiolipin antibodies in the pathogenesis of heart valve disease in patients with SLE.

[Osteoporosis in ankylosing spondylitis: comparison of dual-energy X-ray absorptiometry (DXA) and quantitative ultrasonography (QUS)]. / Osteoporoza u chorych na zesztywniajace zapalenie stawów kregoslupa: porównanie techniki absorpcjometrii promieniowania rentgenowskiego (DXA) oraz techniki ultradzwiekowej (QUS).

The aim of this study was to determine bone mineral density (BMD) of the forearm and of the femoral neck using DXA technique and evaluation of broadband ultrasound attenuation (BUA) and speed of sound (SOS) of the heel using QUS technique in patients with ankylosing spondylitis (AS). The group of 59 AS patients were involved in the study: 53 male and 6 female with average age (40.0 +/- 8.2 yrs), range 29 to 49. Average disease duration was 160.6 +/- 98.0 months, range 18 to 420 months. AS patients were compared to 60 healthy controls: 50 male and 10 non post-menopausal female (average age 38.2 +/- 7.4 yrs). FA-BMD (distal radius) was evaluated using DTX-200 (Osteometer Medi-Tech A/S Denmark) and FN-BMD using ECLIPSE (Norland Medical Systems, Inc., Fort Atkinson, WI). QUS parameters of the left heel (BUA and SOS) were measured by DTU-ONE (Osteometer Medi-Tech A/S Denmark). AS patients are related only to low bone mass of femoral neck (0.786 g/cm2 vs 0.901 g/cm2, p < 0.001). This group relative young patients with chronic inflammatory process is in the increased risk group of hip fracture. QUS measurements of the heel and DXA of forearm do not appear to be a good predictor for screening of AS pts with osteoporosis.