Left ventricular systolic function in patients with systemic lupus erythematosus and its association with cardiovascular events

Gegenava, T.; Gegenava, M.; Steup-Beekman, G.M.; Huizinga, T.W.J.; Bax, J.J.; Delgado, V.; Marsan, N.A. (2020)

Article / Letter to editor

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with potential cardiovascular involvement. The aim of this study was to assess left ventricular (LV) systolic function in a large cohort of patients with SLE using standard echocardiographic measurements and global longitudinal strain (GLS) by two-dimensional speckle-tracking analysis. Furthermore, the association between echocardiographic parameters and the occurrence of cardiovascular events was assessed.Methods: A total of 102 patients with SLE (88% women; mean age, 43 +/- 14 years) undergoing a dedicated multidisciplinary assessment were analyzed, including echocardiography, at the time of their first visit. A control group consisted of 50 age- and sex-matched healthy subjects.Results: Compared with control subjects, patients with SLE showed impaired LV systolic function on the basis of LV ejection fraction (51 +/- 6% vs 62 +/- 6%, P < .001) and by LV GLS (-15 +/- 3% vs -19 +/- 2%, P < .001). During a median follow-up period of 2 years (interquartile range, 1-6 years), 38 patients (37%) developed cardiovascular events. Kaplan-Meier survival curves showed that patients with SLE with more impaired LV GLS (on the basis of the median value of -15%) experienced higher cumulative rates of cardiovascular events compared with those with less impaired LV GLS (chi(2) = 8.292, log-rank P = .004). On multivariate Cox regression analysis, LV GLS demonstrated an independent association with cardiovascular events (hazard ratio, 2.171; 95% CI, 1.015-4.642; P = .046), whereas LV ejection fraction was not significantly associated with the outcome.Conclusions: In patients with SLE, LV systolic function as measured by LV GLS is significantly impaired and associated with cardiovascular events, potentially representing a new tool to improve risk stratification in these patients.

• Left ventricular function
• global longitudinal strain
• systemic lupus erythematosus
• cardiovascular outcome

• All authors: Gegenava, T.; Gegenava, M.; Steup-Beekman, G.M.; Huizinga, T.W.J.; Bax, J.J.; Delgado, V.; Marsan, N.A.
• Date: 2020-09-01
• Journal: Journal of The American Society of Echocardiography
• Volume: 33
• Issue: 9
• Pages: 1116 - 1122
• DOI: doi:10.1016/j.echo.2020.04.018
• Link: https://www.sciencedirect.com/science/article/pii/S0894731720302303?via%...