CARDIAC INVOLVEMENT IN SYSTEMIC LUPUS-ERYTHEMATOSUS DETECTED BY ECHOCARDIOGRAPHY

Cardiac involvement in patients with systemic lupus erythematosus (SLE) was assessed by full echocardiography and continuous wave Doppler in 50 consecutive patients and 50 age- and sex-matched control subjects in a prospective, blinded study. The left ventricular ejection fraction was decreased in patients compared to control subjects (61 ± 9 vs 68 ± 7%, p < 0.001), whereas interventricular septum (12 ± 3 vs 9 ± 1 mm, p < 0.001), and posterior wall dimension (9 ± 2 vs 8 ± 1 mm, p < 0.001), left ventricular mass (186 ± 54 vs 130 ± 32 g, p < 0.001) and mitral valve Doppler A:E ratio (0.8 ± 0.2 vs 0.7 ± 0.1, p < 0.01) were increased. Pericardial effusion was detected in 27 patients and 5 control subjects, and valvular regurgitation was more frequent in the patients (aortic 2 vs 0; mitral 23 vs 5, p < 0.001; tricuspid 34 vs 22, p < 0.01 and pulmonary 28 vs 17, p < 0.05). Mitral or aortic regurgitation was more common in patients with active SLE (60 vs 40%, difference not significant) but was not related to the duration of SLE (r = 0.02), duration of prednisone therapy (r = -0.13) or current dosage of prednisone (r = 0.01). This study demonstrates that pericardial effusion, valvular regurgitation and myocardial abnormalities are frequently present in patients with SLE. © 1990.