Left ventricular size and function in patients with systemic lupus erythematosus associate with lupus anticoagulant: An echocardiographic follow-up study

被引:4
作者
Myhr, Katrine A. [1 ]
Zinglersen, Amanda H. [2 ]
Hermansen, Marie-Louise F. [2 ]
Jepsen, Mathies M. [1 ]
Iversen, Katrine K. [2 ]
Ngo, Anh T. [1 ]
Pecini, Redi [1 ]
Jacobsen, Soren [2 ]
机构
[1] Rigshospitalet, Dept Cardiol, Inge Lehmanns Vej 7, DK-2100 Copenhagen, Denmark
[2] Rigshospitalet, Copenhagen Res Ctr Autoimmune Connect Tissue Dis, Ctr Rheumatol & Spine Dis, Juliane Maries Vej 10, DK-2100 Copenhagen, Denmark
关键词
Systemic lupus erythematosus; Lupus anticoagulant; Echocardiography; Diastolic dysfunction; Pathophysiology; EUROPEAN ASSOCIATION; DISEASE-ACTIVITY; ANTIPHOSPHOLIPID ANTIBODIES; CHAMBER QUANTIFICATION; DIASTOLIC DYSFUNCTION; CARDIOVASCULAR EVENTS; CARDIAC DYSFUNCTION; AMERICAN SOCIETY; REVISED CRITERIA; RISK-FACTORS;
D O I
10.1016/j.jaut.2022.102884
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with increased risk of cardiac dysfunction. The pathophysiological mechanisms are poorly understood, and prognostic markers are warranted. Purpose: We aimed to identify SLE-characteristics associated with measures of cardiac size and function during a five-year follow-up. Methods: We included 108 patients with SLE: 90% females, mean age 46 +/- 13 years, median disease duration 14 (range 7-21) years. We performed blood sampling for potential biomarkers as well as a standard echocardiography at baseline and at a 5-year follow-up. To investigate associations with baseline and prospective 5-year changes in echocardiographic parameters, we performed multivariate regression analyses of SLE-related base-line variables (clinical disease activity, lupus nephritis, chronic kidney disease, anti-cardiolipin and/or anti-beta -2 glycoprotein I antibodies, and lupus anticoagulant (LAC)) and adjusted for traditional risk factors. Results: During follow-up, diastolic function regressed in two out of five echocardiographic measures (E/A ratio 1.4 +/- 0.5 vs. 1.3 +/- 0.5, p = 0.002; tricuspid regurgitation peak velocity 2.0 +/- 0.6 vs. 2.2 +/- 0.4 mmHg, p < 0.001). Left ventricular (LV) end-diastolic volume index increased (43.7 +/- 13.9 vs. 52.5 +/- 15.7 mL/m2, p < 0.001). Left and right ventricular systolic function remained stationary. LAC was associated with inferior diastolic function: lower E/A ratio (p = 0.04) and higher E/e' ratio at baseline (p = 0.04) and increased left ventricular atrial volume index during follow-up (p = 0.01). LAC was further associated with LV dilatation during follow-up (p = 0.01). Conclusion: Presence of LAC was associated with measures of diastolic function as well as progressive LV dilatation during the 5-year follow-up. Thus, LAC might be a predictor of cardiac dysfunction in SLE patients. LAC is known to have implications for the microvascular circulation, but the clinical significance of the present findings is yet to be elucidated.
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页数:8
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