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Abstract
Purpose Patients with systemic lupus erythematosus (SLE) have an increased risk of developing a cardiovascular event than the general population, due to immunological factors and a systemic inflammatory state. We aimed to evaluate the association of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) 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. Patients with a previous cardiovascular event (myocardial infarction, stroke or peripheral artery disease), another connective tissue disease, or pregnancy were excluded. A transthoracic echocardiogram was performed by two certified echocardiographers blinded to clinical information. Disease activity was assessed with SLEDAI. Distribution of quantitative variables was evaluated with the Kolmogorov-Smirnov test. Correlations between SLEDAI and echocardiographic parameters were assessed 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. Median SLEDAI was 8 (4–12). Demographic and clinical characteristics are shown in Table 1. We found a moderate positive correlation between SLEDAI and left ventricular mass index (rs = 0.313, p = 0.010), and between SLEDAI and the ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e’) (rs = 0.347, p = 0.005) (Figure 1).
Demographic and clinical characteristics
Scatter plots of correlations between SLEDAI and echocardiographic parameters
Conclusions Higher SLEDAI score was associated with higher left ventricular mass index and E/e’. An increased left ventricular mass index could lead to the development of left ventricular hypertrophy, and an increased E/e’ could lead to the development of diastolic dysfunction, which are associated with higher risk of cardiovascular mortality. A transthoracic echocardiogram may be helpful to detect early cardiovascular abnormalities, especially in patients with high disease activity, and therefore, should be considered as part of the cardiovascular evaluation in this specific population.
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