Abstract 5737: Disease Chronicity and Activity Predicts Subclinical Left Ventricular Systolic Dysfunction in Patients with Systemic Lupus Erythematosus
Objective: To investigate evidence and predictors of subclinical myocardial dysfunction in systemic lupus erythematosus (SLE) in absence of valvular, clinical coronary artery and pericardial disease.
Methods and Results: Eighty-two female SLE (49±9 years) and 40 normal female subjects (45±9 years) matched for age, body mass index, blood pressure and heart rate, underwent standard and tissue Doppler imaging (TDI). Twenty-two (27%) patients had impaired long-axis left ventricular (LV) function with mean 6-basal segment peak systolic velocity (Sm) <4.4cm/s, despite having comparable normal LV ejection fraction, cardiac index, and right ventricular fractional area change with the control group. Patients with subnormal mean Sm were older (49±8 versus 44±9; p=0.043), had longer disease >10 years (82% versus 50%, p=0.01), higher prevalence of hypertension (46% versus 22%; p=0.034), disease activity score (76% versus 51% for SLEDAI ≥1, p=0.045), and end-organ damage index (64% versus 47% with SLICC ≥1, p=0.049) than those with normal values. Disease duration >10 years, disease activity index, increased arterial stiffness, and impaired midwall fractional shortening <0.15 provided additional incremental predictive value of LV long-axis dysfunction.
Conclusion: SLE patients have subclinical long-axis dysfunction. These data suggest regular cardiac function monitoring by TDI for patients who have SLE >10 years, with frequent flare or arterial stiffening.