Abstract 5735: Left Ventricular Longitudinal Function Is Impaired In Patients With Systemic Lupus Erythematosus
Background: Systemic lupus erythematosus (SLE) is frequently associated with premature atherosclerosis and vascular stiffening. Whether SLE alters left ventricular structure and function in the absence of valvular and clinical coronary artery disease and whether these abnormalities can be detected by new echocardiographic imaging modalities is unknown. We describe the echocardiographic characteristics in patients with SLE without any clinical presentation or history of cardiovascular pathology, coronary artery disease or heart failure.
Methods and Results: The subjects of the study (n= 67) were age and gender matched to a reference group (n= 40) and underwent standard transthoracic echocardiography including tissue doppler imaging (TDI), strain rate (SRR) and strain (STR) imaging. Disease characteristics were evaluated in SLE patients. The two groups were similar in subjects’ body size, body mass, diabetes status, hyperlipidaemia and smoking status. The subjects displayed significantly impaired systolic and diastolic myocardial velocities measured by TDI and a reduction in SRR and STR were detected in SLE (p<0.001). They also presented a significantly enhanced E/E′ ratio (p<0.001). Interestingly, SLE with arterial hypertension did not present further reduced strain values compared to SLE without hypertension. SLE with a higher disease activity in the ECLAM score revealed a significant reduction of the longitudinal left ventricular function in STR (p<0.01) and SRR (p<0.05).
Conclusions: SLE is associated with longitudinal myocardial dysfunction of the left ventricle, which may contribute to the increased cardiac morbidity and mortality observed in SLE patients. The decrease in the peak systolic and diastolic TDI, SRR and STR allows an early detection of myocardial dysfunction. A higher disease activity score is associated with a further reduction in longitudinal left ventricular function. Strain imaging seems to be superior to standard two-dimensional echocardiographic imaging, which is less sensitive to detect preclinical myocardial disease in SLE.