Echocardiographic findings in systemic lupus erythematosus and its relation to disease activity and damage index

Abstract

Aim of the workTo assess the echocardiographic changes using Trans Thoracic Echocardiograghy in systemic lupus erythematosus (SLE) patients with and without antiphospholipid syndrome (APS) and to study the relation of the changes to the disease activity and damage. Patients and methodsThis study was conducted on 50 SLE patients (25 with and 25 without APS) and 50 controls. The SLE disease activity index (SLEDAI) and Systemic Lupus International Collaborating Clinics Damage index (SLICC/DI) were assessed. Laboratory investigations were performed and transthoracic echocardiography (TTE) was done. ResultsThe mean age of the patients was 27.7 ± 8.5 years and disease duration 4.1 ± 3.7 years; 44 females and 6 males; 7.3:1. There was a high frequency of mitral (64%), aortic (22%) and tricuspid (24%) valve regurges as well as pericardial effusion (22%). Left ventricular hypertrophy and atrial dilation was present in 10% of the patients. The frequency of mitral, aortic and tricuspid regurge in SLE patients with APS tended to be higher (84%, 32% and 36%) than in those without (44%, 12% and 12%, respectively). There was a significant correlation between SLEDAI and pericardial effusion (p = 0.001), between the SLICC/DI with the left ventricular diastolic dysfunction (LVDD) (p = 0.001), the presence of lupus nephritis with the ejection fraction (p = 0.02) and between hypertension with the LVDD (p = 0.001). ConclusionAll SLE patients especially those with APS should be screened for the presence of structural cardiac abnormalities. TTE can be helpful as a noninvasive diagnostic tool for early detection of the abnormalities, resulting in earlier treatment and reduction in mortality and morbidity.