AB0540 Usefulness of cardiac screening in patients with systemic lupus erythematosus and anti-ro positive antibodies
Authors: A. Olivé, M. Martínez-Morillo, R. Villuendas, A. Teniente-Serra, A. Riveros-Frutos, S. Heredia, Á. Prior-Español, S. Holgado, L. Mateo, M. Aparicio, L. Gifre, G. Juncà, E. Martínez-Cáceres, A. Bayes-Genis
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Cardiac block in neonatal lupus is associated with placental transfer of anti-Ro antibodies. The effect of these antibodies on cardiac conduction disorders in adult patients is controversial. The association between anti-Ro antibodies and heart rhythm disorders have been described in isolated cases. However, there are just a few studies that analyse the relationship between autoimmune diseases and electrocardiographic disturbances. <h3>Objectives</h3> To determine if there are differences in cardiac conduction of SLE patients in presence of anti-Ro antibodies. <h3>Methods</h3> All patients included fulfilled the SLE criteria, SLICC 2012 and they were followed up in a single centre. The inclusion was consecutive and voluntary. Patients who took drugs that altered the conduction (except antimalarial drugs), and those who had heart or thyroid disease were discarded. All patients were assessed blindly by a cardiologist who performed an interrogation and physical examination, an electrocardiogram, an echocardiogram and a 24 hour Holter study. Besides, a rheumatologist performed a clinical and analytical assessment including a qualitative analysis by immunoblotting of anti-Ro Ab and a quantification by chemiluminescence of the anti-Ro52 and Ro60 Ab. The presence of other SLE specific Ab (ANA, DNA, antiphospholipids), was also analysed. Clinical, analytical and, activity and damage indexes, were collected (SLEDAI and SLICC). The data were compared by Student's t test, Fisher's test and Chi square using 21 SPSS version. The level of significance was established at 5%. <h3>Results</h3> 145 patients were included: 91.7% women, average age 45±12, average disease duration 11 years. The patients were undergoing the following treatments: antimalarial 91%, mycophenolate 20%, azathioprine 12%, biological treatment 5% and glucocorticoids 70%. The clinical characteristics are summarised in table 1. There were no significant differences between the group of positive and negative anti-Ro Ab in terms of gender, age, clinical characteristics or cardiovascular risk factors. None of the patients was affected by an atrio-ventricular block and the rest of the electrocardiographic alterations had no clinical significance and did not predominate in the positive Ro Ab group. Additionally, no differences in heart rate, ventricular extrasystoles or PR, QT or QRS intervals were detected between both groups. The echocardiogram's findings were not relevant and there were no differences between groups. Since the majority of patients with SLE are double positive, differences between the two subspecificities of Ro (52 and 60) could not be analysed. On the other hand, no differences were found in cardiac conduction regarding the treatments received, the activity or damage indexes, or the analytical or clinical characteristics of the patients. <h3>Conclusions</h3> The study results show that there are no differences in cardiac conduction according to the presence of anti-Ro antibodies in SLE patients. Thus, the cardiac screening in SLE patients with anti-Ro positive antibodies seems not helpful in clinical practice. <h3>Disclosure of Interest</h3> None declared