الفهرس 
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Abstract
Summary
Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease that may involve many different organs and display a variable clinical course .The diagnosis of SLE is based on characteristic clinical findings of the skin, joints, kidneys, heart and the central nervous system, as well as on serological parameters such as antinuclear antibodies (ANA), in particular antibodies to dsDNA. The various clinical symptoms do not always occur simultaneously and may develop at any stage of the disease (Kuhn et al., 2015).
Cardiovascular system involvement in SLE might be associated with disease severity and activity (Doria et al., 2005a). Cardiac involvement as an initial manifestation of SLE is rare; however, in more than 50 % of cases, the cardiac involvement is associated with significant morbidity and mortality rates (Nossent et al., 2007).
Antiphospholipid syndrome (APS) also can affect the cardiovascular system and many of the cardiopulmonary manifestations of SLE are recognized in APS (Paran et al., 2004).
The aim of this study was to assess echocardiographic changes in Systemic Lupus Erythematosus patients, comparing the echocardiographic changes between SLE patients without APS and those with APS patients and its correlation with disease activity and damage index.
This study was conducted on 50 clinically diagnosed SLE patients (25 without APS and 25 with APS) And 50 healthy controls.The patients were diagnosed according to Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE (petri et al., 2012).
All were subjected to full clinical history and examination, complete blood count, ESR, C-reactive protein, ANA,LA, ACL IgG, ACL IgM ds-DNA, C3, C4,liver enzymes ,serum creatinine, urea ,lipid profile ,Complete urine analysis ,24 hours urinary protein and transthoracic echocardiography (VividS5) machine.
This study demonstrated the following: In comparing echocardiograhic findings in SLE patients and control subjects, there was highly statistically significant difference as regards: MR, AR, TR & Pericardial effusion. There was statistically significant difference LVH and Left Atrial Dilation. There was no statistically significant difference as regards: PASP, LVDD and PR.
The incidence of valvular regurgitation was more frequent in SLE patients with APS than in SLE patients without APS. In our study there was highly statistically significant positive correlation between SLICC damage index and LVDD. There was statistically significant negative correlation between lupus nephritis and ejection fraction. And there was highly statistically significant positive correlation between SLEDAI and pericardial effusion.