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Cardiac involvement in systemic lupus erythematosus detected by echocardiography
1Department of Medicine, Prince of Wales Hospital.
Insights
Systemic lupus erythematosus (SLE) frequently causes cardiac issues, including pericardial effusion, valvular regurgitation, and myocardial abnormalities. Echocardiography revealed significant differences in cardiac function and structure in SLE patients compared to controls.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with potential multi-organ involvement.
- Cardiac manifestations are a significant cause of morbidity and mortality in SLE patients.
- Early detection and characterization of cardiac involvement are crucial for patient management.
Purpose of the Study:
- To assess the prevalence and characteristics of cardiac involvement in patients with SLE.
- To compare echocardiographic findings in SLE patients with those in age- and sex-matched healthy controls.
- To investigate potential correlations between cardiac abnormalities and disease activity or treatment in SLE.
Main Methods:
- A prospective, blinded study involving 50 consecutive SLE patients and 50 matched controls.
- Comprehensive echocardiography and continuous wave Doppler assessments were performed.
- Data analysis included comparisons of cardiac structural and functional parameters between groups.
Main Results:
- SLE patients exhibited decreased left ventricular ejection fraction (61% vs 68%) compared to controls.
- Increased interventricular septum (12mm vs 9mm), posterior wall dimension (9mm vs 8mm), and left ventricular mass (186g vs 130g) were observed in SLE patients.
- Pericardial effusion (27% vs 5%) and valvular regurgitation (mitral, tricuspid, pulmonary) were significantly more frequent in SLE patients.
Conclusions:
- Cardiac abnormalities, including pericardial effusion, valvular regurgitation, and myocardial dysfunction, are common in SLE patients.
- Echocardiography is a valuable tool for detecting subclinical cardiac involvement in SLE.
- These findings underscore the importance of cardiac monitoring in the management of SLE.
Abstract:
Cardiac involvement in patients with systemic lupus erythematosus (SLE) was assessed by full echocardiography and continuous wave Doppler in 50 consecutive patients and 50 age- and sex-matched control subjects in a prospective, blinded study. The left ventricular ejection fraction was decreased in patients compared to control subjects (61 +/- 9 vs 68 +/- 7%, p less than 0.001), whereas interventricular septum (12 +/- 3 vs 9 +/- 1 mm, p less than 0.001), and posterior wall dimension (9 +/- 2 vs 8 +/- 1 mm, p less than 0.001), left ventricular mass (186 +/- 54 vs 130 +/- 32 g, p less than 0.001) and mitral valve Doppler A:E ratio (0.8 +/- 0.2 vs 0.7 +/- 0.1, p less than 0.01) were increased. Pericardial effusion was detected in 27 patients and 5 control subjects, and valvular regurgitation was more frequent in the patients (aortic 2 vs 0; mitral 23 vs 5, p less than 0.001; tricuspid 34 vs 22, p less than 0.01 and pulmonary 28 vs 17, p less than 0.05). Mitral or aortic regurgitation was more common in patients with active SLE (60 vs 40%, difference not significant) but was not related to the duration of SLE (r = 0.02), duration of prednisone therapy (r = -0.13) or current dosage of prednisone (r = 0.01). This study demonstrates that pericardial effusion, valvular regurgitation and myocardial abnormalities are frequently present in patients with SLE.