AB0329 HIGHER PREVALENCE OF ECHOCARDIOGRAPHIC ABNORMALITIES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: N. Guajardo-Jauregui, J. R. Azpiri-López, D. Á. Galarza-Delgado, I. J. Colunga-Pedraza, R. A. Reyna-de la Garza, S. Lugo-Perez, A. B. Rodriguez-Romero, A. Cárdenas, H. Azpiri-Diaz, O. A. Cepeda-Ayala
Journal: Annals of the Rheumatic Diseases (2021)

Background: Systemic lupus erythematosus (SLE) is a chronic, inflammatory, and autoimmune disease that damages vital organs such as the heart. Patients with SLE have a higher risk of developing a cardiovascular (CV) disease than the general population (1). Objectives: The aim of this study was to compare the echocardiographic findings in patients with SLE and controls. Methods: This was a cross-sectional, observational, and comparative study. A total of 38 patients with SLE according to the 2019 EULAR/ACR classification criteria, ≥18 years old and 38 matched controls by age (±5 years) and gender, were recruited for this study. Exclusion criteria were a poor echocardiographic window, patients with a previous CV event, such as myocardial infarction, cerebrovascular event or peripheral arterial disease, and pregnant women. A transthoracic echocardiogram, including speckle tracking technique, was performed, by two certified echocardiographers, in all study subjects. Distribution was evaluated with Kolmogorov-Smirnov test. Comparisons were done with χ 2 and Fisher´s Exact test for qualitative variables, and Student’s t test and Mann-Whitney´s U test for quantitative variables. A p -value &lt;0.05 was considered statistically significant. Results: When comparing demographic characteristics there were no significant differences in age, gender, and comorbidities between SLE patients and controls. In the echocardiographic findings a significant difference was found in the left ventricular ejection fraction (LVEF), lower in SLE patients compared to controls (57.02% vs 61.89%, p =0.001), in the global longitudinal strain (GLS), reduced in SLE patients (-19.55% vs -22.00%, p =0.001), in the tricuspid annular plane systolic excursion (TAPSE), lower in SLE patients (22.00mm vs 24.00mm, p =0.011), in the left atrial volume index, higher in SLE patients (28.44ml/m 2 vs 22.29ml/m 2 , p =0.014) and in the presence of mitral regurgitation, more prevalent in SLE patients (31.6% vs 10.5%, p =0.024) (Table 1). Conclusion: Patients with SLE have a worse left ventricular function, evaluated by LVEF and GLS, a worse right ventricular systolic function, evaluated by TAPSE, an increased left atrial volume index and a higher prevalence of mitral regurgitation, which are associated with a higher risk of CV death. It is important to consider including a transthoracic echocardiogram as part of the CV evaluation in patients with SLE, which may result in an early detection of CV abnormalities and an opportune treatment. References: [1]Avina-Zubieta JA, To F, Vostretsova K, et al. Risk of Myocardial Infarction and Stroke in Newly Diagnosed Systemic Lupus Erythematosus: A General Population-Based Study. Arthritis Care Res (Hoboken) 2017;69(6):849-56. doi: 10.1002/acr.23018 Table 1. Demographic characteristics and echocardiographic findings. SLE patients (n=38 ) Controls (n=38 ) p Age years, median (p25-p75) 37.5 (24.5-43.2) 45.0 (24.0-50.0) NS Women, n (%) 34 (89.5) 37 (97.4) NS T2DM, n (%) 1 (2.6) 3 (7.9) NS HTN, n (%) 9 (23.7) 3 (7.9) NS Dyslipidemia, n (%) 3 (7.9) 3 (7.9) NS Obesity, n (%) 1 (2.6) 5 (13.2) NS Active smoking, n (%) 7 (18.4) 3 (7.9) NS Echocardiographic findings Left ventricle indexed mass g/m 2 , median (p25-p75) 64.00 (50.66-87.09) 60.30 (52.97-76.74) 0.009 RWT, median (p25-p75) 0.37 (0.30-0.46) 0.38 (0.33-0.45) NS Left ventricular ejection fraction %, mean ± SD 57.02 ± 7.37 61.89 ± 5.23 0.001 Global longitudinal strain %, median (p25-p75) -19.55 (-21.02 – -15.95) -22.00 (-21.00 – -20.00) 0.001 Left atrium indexed volume ml/m 2 , median (p25-p75) 28.44 (20.34-33.56) 22.29 (17.97-27.13) 0.014 TAPSE mm, median (p25-p75) 22.00 (20.00-24.00) 24.00 (21.00-25.00) 0.011 Valvular abnormalities Aortic regurgitation, n (%) 2 (5.3) 1 (2.6) NS Mitral regurgitation, n (%) 12 (31.6) 4 (10.5) 0.024 Tricuspid regurgitation, n (%) 16 (42.1) 17 (44.7) NS SLE, systemic lupus erythematosus; NS, not significant; T2DM, type 2 diabetes mellitus; HTN, hypertension; RWT, relative wall thickness; TAPSE, tricuspid annular plane systolic excursion. Acknowledgements: We have no acknowledgements to declare. Disclosure of Interests: None declared