Abstract
Purpose Systemic lupus erythematosus (SLE) is a chronic inflammatory disease, characterized by the deposition of immunocomplexes in vital organs such as the heart, brain, and kidneys. High autoantibodies titers have been associated with a worse cardiovascular prognosis. Anti-double stranded DNA (anti-dsDNA) antibody has been associated with skin, brain and kidney injury, however, information about its association with cardiovascular risk is scarce. We aimed to evaluate the association between measure anti-dsDNA antibody titers and echocardiographic parameters in SLE patients.
Methods This was a cross-sectional study. We recruited a total of 67 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. A blood sample was drawn to measure anti-dsDNA titers. Distribution was evaluated with the Kolmogorov-Smirnov test. Correlations between anti-dsDNA antibody titers and echocardiographic parameters were determined with Spearman’s correlation coefficient (rs). A p-value < 0.05 was considered statistically significant.
Results Median age of SLE patients was 37 (24–42) years, 89.6% were women, and 20.9% had hypertension diagnosis. Demographic and clinical characteristics are shown in Table 1. We found a moderate positive correlation between anti-dsDNA antibody titers and left ventricular mass index (rs = 0.332, p = 0.006), a moderate positive correlation between anti-dsDNA antibody titers and the ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e’) (rs = 0.368, p = 0.003), and a moderate positive correlation between anti-dsDNA and pulmonary arterial systolic pressure (PASP) (rs = 0.326, p = 0.013) (Table 2).
Conclusions Higher titers of anti-dsDNA antibody are associated with higher left ventricular mass index, E/e’, and PSAP, which could lead to the development of ventricular hypertrophy, diastolic dysfunction, and pulmonary hypertension respectively. The performance of a transthoracic echocardiogram may be helpful to detect early cardiovascular abnormalities in SLE patients, especially those with high anti-dsDNA antibody titers.