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Clinical Risk Predictors for Abnormal Left Ventricular and Atrial Function in Lupus Erythematosus.
Matteo Morello1, Bethany Gholson1, Weiting Huang1
1Cardiovascular Division and Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, Virginia.
Summary
Reduced global longitudinal strain (GLS) is common in systemic lupus erythematosus (SLE) and linked to heart failure symptoms and greater disease severity, particularly pericardial involvement. This suggests shared immune mechanisms contribute to cardiac dysfunction in SLE patients.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) can cause ventricular dysfunction through direct immune attack or comorbidities.
- Understanding predictors of left ventricular (LV) dysfunction is crucial for developing mitigation strategies.
Purpose of the Study:
- To identify clinical predictors of reduced LV systolic and diastolic function in SLE patients.
- To explore potential strategies for mitigating cardiac dysfunction in SLE.
Main Methods:
- Retrospective study of 76 SLE patients undergoing echocardiography.
- Correlation of clinical, laboratory, and echocardiographic features.
- Definition of abnormal LV systolic function using global longitudinal strain (GLS) threshold of -18.0%.
Main Results:
- Reduced GLS observed in 24% of patients, with 44% having LV ejection fractions <50%.
- Heart failure symptoms were more common in the reduced GLS group (50% vs 12%).
- Reduced GLS associated with greater SLE severity, including renal and pericardial involvement, and impaired right ventricular and left atrial function.
Conclusions:
- Reduced GLS is prevalent in SLE and linked to heart failure symptoms and markers of disease activity.
- Pericardial involvement, renal disease, and impaired diastolic function are associated with reduced GLS.
- Shared immune mechanisms may underlie cardiac dysfunction, including impaired GLS, diastolic function, and left atrial reservoir strain (LASr) in SLE.
