Echocardiographic findings in patients with Wegener granulomatosis

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.