Purpose It is estimated that approximately 40% of systemic lupus erythematosus (SLE) patients develop lupus nephritis (LN) throughout the evolution of the disease. In a previous study, patients with LN had 8 times more risk of myocardial infarction and 4 times more risk of cardiovascular mortality than SLE patients without LN. Therefore, we aimed to compare the echocardiographic parameters between SLE patients with and without LN.
Methods This was a cross-sectional study nested of a SLE cohort. We recruited patients with SLE diagnosis according to the 2019 EULAR/ACR classification criteria, aged ≥ 18 years. A transthoracic echocardiogram was performed by two certified echocardiographers blinded to clinical information. Patients with LN were included and matched to patients without LN by age (± 5 years) and gender. Distribution was evaluated with the Kolmogorov-Smirnov test. Comparisons were done with Chi-square or Fisher’s exact test for qualitative variables, and Student’s T-test or Mann-Whitney’s U-test for quantitative variables. A p-value < 0.05 was considered statistically significant.
Results A total of 48 SLE patients, 24 with LN and 24 without LN, were included. Mean age of patients with LN was 36.9 ± 10.4 years, compared to 36.5 ± 9.3 years in patients without LN, p = 0.873. There was a higher prevalence of hypertension in patients with lupus nephritis, however, the comparison was not significant. The demographic characteristics are shown in Figure 1. When comparing the echocardiographic parameters between groups, we found a significant difference in the left ventricular mass index, which was higher in LN patients (66.9 g/m2 vs 54.8 g/m2, p = 0.035). The comparisons of echocardiographic parameters between both groups are shown in Table 1.
Conclusions Patients with LN had higher left ventricular mass index than patients without LN. An increased left ventricular mass could lead to the development of ventricular hypertrophy and diastolic dysfunction, which are associated to higher cardiovascular mortality. The performance of a transthoracic echocardiogram should be considered as part of the cardiovascular evaluation of SLE patients, especially those with LN.
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