AB1071 IMPACT OF DISEASE DURATION AND SEROLOGY WITH HEART VALVE DISEASE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: M. F. Elizondo-Benitez, A. L. Guajardo-Aldaco, D. A. Galarza-Delgado, J. R. Azpiri-Lopez, I. J. Colunga-Pedraza, J. A. Cardenas-de la Garza, R. I. Arvizu-Rivera, V. Gonzalez-Gonzalez
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disease characterized by multiple organ damage and a high cardiovascular mortality rate. Valvular Heart Disease (VHD) is a known cardiac manifestation of SLE. Involvement of the mitral valve is most frequently encountered. Valve replacement in SLE patients is established as the most common cardiac surgery, with a mean of 24 months of disease duration. <h3>Objectives:</h3> To compare the prevalence of heart valve disease in patients with SLE according to the duration of their disease and seropositivity. <h3>Methods:</h3> Cross-sectional, observational, and comparative study of SLE patients who met the classification criteria of ACR/EULAR 2019, aged over 18 years old. Exclusion criteria: overlapping syndromes, major cardiovascular events (myocardial infarction, stroke, heart failure), and pregnancy. Disease duration was defined through medical history, and patients were divided into two groups: ≤24 months and &gt;24 months. A transthoracic echocardiogram was performed on all patients by a certified cardiologist, who was blinded to clinical information. The presence of valvular alterations was defined according to the report obtained by cardiology (aortic, mitral, or tricuspid insufficiency). Serology was obtained through a laboratory exam. Group distribution was assessed using the Kolmogorov-Smirnov test. Comparisons were made using the Chi-square test, Fisher's exact test, the Student's T-test, or Mann-Whitney U test, as appropriate. A <i>p</i>-value ≤0.05 was considered statistically significant. <h3>Results:</h3> Eighty-one patients with SLE were included, mostly women (91.3%), with an average age of 35.3 ± 12.3 years. Most patients were classified as having moderate SLE-Disease Activity Index (SLEDAI) scores (n=27, 32.9%). Patients with ≤24 months post-diagnosis had a higher prevalence of mild tricuspid regurgitation (34.7% vs 6.5%, <i>p</i>=0.001), and a higher prevalence of trivial tricuspid regurgitation in the group with &gt;24 months (30.4% vs 63.9%, <i>p</i>=0.010). There was no significant difference in aortic (43.4% vs 34.4%, <i>p</i>=0.12) and mitral (60.8% vs 47.5%, <i>p</i>=0.25) valve involvement (Table 1). A sub-analysis was performed between the patients with valve regurgitation and the seropositivity of anti-Smith (9.6%, <i>p=0.06</i>), anti-La (9.6%, <i>p=0.18</i>), anti-Ro (32.2%, <i>p=0.22</i>) antibodies in the same population. There was no significant association between valve regurgitation and the seropositivity of the antibodies (Table 2). <h3>Conclusion:</h3> Mitral valve disease is established as the most common valvulopathy in SLE patients. Our study contradicts previous literature, establishing tricuspid valve regurgitation as the most prevalent one in our population. Close monitoring through echocardiography is an excellent option to detect heart valve disease in early stages and provide a better cardiovascular health prognosis. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>