Echocardiographic findings in systemic lupus erythematosus

Introduction

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by inflammation of multiple organs. The heart may be seriously involved. Aim of study: to investigate the cardiac involvement in patients diagnosed with SLE assessed from an echocardiographic view.

Method

We retrospectively reviewed the records of 75 patients with diagnosis of SLE based on the American College of Rheumatology criteria and who were referred to our echocardiography laboratory between 2010 to 2022. All echocardiographic exams were carried by transthoracic way.

Results

Patients were female in 92% of cases. Mean age was 27.8 years (16–70 years). Echocardiography showed 17 cases (22%) of minim or moderate pericardial effusion, tamponadein 2 cases. Valvularabnormalities were observed in 19 cases (25%), this included thickening of valves in all cases associated to 6 cases of significant mitral regurgitation (> grade 1) and 2 cases of Libman sacks mitral valve endocarditis. However, aortic involvement was noted only in 3 cases resulting in thickening and mild regurgitation. Myocardium was involved in 5 cases (6%) including dilated left ventricular in 3 cases and hypertrophy in 2 cases. High arterial pulmonary hypertension was reported in 4 cases (5%) with mean systolic pulmonary arterial pressure was 59 mmHg (38–120 mmHg).

Conclusion

Patients with SLE have an increased risk of cardiac involvement. In agreement with previous reports, our study shows that pericardial effusion is the most frequent cardiac complication of lupus and Valvular involvement in SLE is relatively frequent but the degree of valvular dysfunction is not important. Echocardiography should be used as a screening tool in these patients, including annual echocardiographic screening of asymptomatic individuals with systemic autoimmunity.