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Published on: February 20, 2017
Evaluation of cardiac function using echocardiography in childhood-onset systemic lupus erythematosus patients
Seher Sener1, Yusuf Ziya Sener2, Ezgi Deniz Batu1
1Division of Pediatric Rheumatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Insights
Long-term hydroxychloroquine treatment in childhood-onset systemic lupus erythematosus (cSLE) patients did not negatively impact cardiac function or left ventricular mass. Regular cardiac monitoring is still recommended for these patients.
Area of Science:
- Pediatric Rheumatology
- Cardiology
- Pharmacology
Background:
- Childhood-onset systemic lupus erythematosus (cSLE) requires long-term management.
- Hydroxychloroquine is a common treatment for cSLE.
- Potential cardiac side effects of hydroxychloroquine warrant investigation in pediatric populations.
Purpose of the Study:
- To assess the impact of hydroxychloroquine on cardiac function.
- To evaluate left ventricular mass in pediatric patients with cSLE on hydroxychloroquine therapy.
Main Methods:
- Echocardiographic evaluation of 50 cSLE patients in clinical remission.
- Analysis of correlations between cumulative hydroxychloroquine dose and cardiac parameters.
- Comparison of cardiac function in low-dose versus high-dose hydroxychloroquine groups.
Main Results:
- No significant correlation found between cumulative hydroxychloroquine dose and left ventricular ejection fraction, mass index, or geometry.
- No significant impact on diastolic cardiac parameters observed.
- No significant echocardiographic differences between low-dose and high-dose hydroxychloroquine groups.
Conclusions:
- Chronic hydroxychloroquine use in cSLE patients is not associated with adverse cardiac structural or functional changes.
- Long-term hydroxychloroquine therapy appears safe for cardiac function in cSLE.
- Continued cardiac monitoring is advised for cSLE patients on hydroxychloroquine to detect potential cardiotoxicity.
Background:
This study aimed to evaluate the effects of hydroxychloroquine on cardiac functions and left ventricular mass in patients with childhood-onset systemic lupus erythematosus (cSLE).
Research Design And Methods:
Fifty patients with cSLE undergoing treatment with hydroxychloroquine underwent echocardiographic evaluation. All patients exhibited negative disease activity markers and were clinically in remission.
Results:
The median duration of hydroxychloroquine exposure was 7.1 (5.2-9.5) years, with a median cumulative dose of 784.8 (509.5-3437.6) grams. No correlation was identified between the parameters of left ventricular ejection fraction, left ventricular mass index and geometry, and cumulative hydroxychloroquine dose (p = 0.245, p = 0.094, p = 0.146, respectively). Furthermore, no significant correlation was identified between the cumulative dose of hydroxychloroquine and diastolic cardiac parameters (all p > 0.05). A comparison of the patients who received a cumulative dose of hydroxychloroquine below the median dose (the low-dose group) with those who received a higher dose (the high-dose group) revealed no significant differences in the echocardiographic parameters (all p > 0.05).
Conclusions:
The findings of this study indicate that chronic hydroxychloroquine use in patients with cSLE does not result in adverse changes in left ventricular mass or impairment of cardiac functions. However, these patients should undergo regular evaluation to monitor for the potential development of cardiotoxicity.
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