Relationship Between Systemic Lupus Erythematosus Disease Activity Index Scores and Subclinical Cardiac Problems
نویسندگان
1 School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
2 Department of Community Medicine and Public Health, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
3 Associate Professor of Rheumatology, Rheumatic Diseases Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
4 Assistant Professor of Cardiology, Echocardiologist, Atherosclerosis Prevention Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
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چکیده
Background: Systemic lupus erythematosus (SLE) is an autoimmune connective-tissue disease involving multiple organs and systems.Some evidence has demonstrated that disease activity could be associated with increased risk of organ damage.Objectives: The aim of this study was to determine the association between systemic lupus erythematosus Disease Activity Index(SLEDAI) scores and subclinical cardiac involvement.Methods: This cross-sectional study was conducted on 45 SLE patients (88% female; mean age: 31.28.2 years) from 2011 to 2013 inMashhad, Iran. The patients had no clinical signs and symptoms of cardiac problems or risk factors for cardiovascular disease andwere selected consecutively. All patients underwent complete echocardiographic examinations (using two dimensional (2D) tissueDoppler and 2D speckle tracking). Disease activity was evaluated by using the SLEDAI.Results: Patients with higher SLEDAI scores had higher pulmonary artery pressure rates (r = 0.34; P = 0.024; 95% CI (0.086 to 0.595))and SLE durations (r = 0.43; P = 0.004; 95% CI (0.165 to 0.664). The correlation between disease duration and left ventricular masswas also significant (r = 0.43; P = 0.009; 95% CI (0.172 to 0.681)), even after adjusting for age (r = 0.405; P = 0.016). There was nocorrelation between SLEDAI scores or disease duration and the left/right ventricle systolic function parameters. This was true whileassessing the right ventricle’s diastolic function. A statistically significant correlation was found between mitral E/E’ as an index ofleft ventricle diastolic impairment and the SLEDAI scores (r = 0.33; P = 0.037; 95% CI (0.074 to 0.574)) along with disease duration (r= 0.45; P = 0.004; 95% CI (0.130 to 0.662); adjusted for age: r = 0.478; P = 0.002).Conclusions: Echocardiography is a useful noninvasive technique for screening subclinical heart problems in SLE patients. Althoughdisease activity in general should suggest a closer follow-up, regular scanning would enable earlier detection of cardiovascularinvolvement and should not be confined to cases with higher SLEDAI indices or longer disease durations.
