Purpose Patients with systemic lupus erythematosus (SLE) have a higher risk of developing a cardiovascular event, due to multiple factors including a systemic inflammatory state, which is related to an accelerated process of atherosclerosis and endothelial damage. We aimed to compare the echocardiographic findings in patients with SLE and controls.
Methods This was a cross-sectional study. We recruited 57 patients with SLE diagnosis according to the 2019 EULAR/ACR classification criteria, aged ≥ 18 years and 57 matched controls by age (± 5 years) and gender. A transthoracic echocardiogram was performed by two certified echocardiographers blinded to clinical information. Distribution was evaluated with the Kolmogorov-Smirnov test. Comparisons were done with Chi-square 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 There were no significant differences in demographic characteristics between groups, except for hypertension, which was more prevalent in SLE patients (21.1% vs 7.0%, p = 0.031) Demographic characteristics are shown in Table 1. We found a significant difference in the left ventricular ejection fraction (LVEF) (56.50% vs 58.00%, p = 0.049), in the global longitudinal strain (GLS (-19.05% vs -21.00%, p = 0.028), in the tricuspid annular plane systolic excursion (TAPSE) (22.10 mm vs 23.56 mm, p = 0.015), in the presence of diastolic dysfunction (21.1% vs 7.0%, p = 0.031) and in the presence of mitral regurgitation (24.6% vs 10.5%, p = 0.049).
Conclusions Patients with SLE had a worse left ventricular function, evaluated by LVEF and GLS, a worse right ventricular systolic function, evaluated by TAPSE, and a higher prevalence of diastolic dysfunction and mitral regurgitation, which are associated with increased risk of cardiovascular death. It is important to consider including an echocardiogram as part of the cardiovascular evaluation in patients with SLE, which may result in early detection of cardiovascular abnormalities.
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