The contribution of resting heart rate and routine blood tests to the clinical assessment of disease activity in systemic lupus erythematosus.
OBJECTIVE
To contrast the contribution of simple clinical tests, such as resting heart rate (HR), complete blood count (CBC), and erythrocyte sedimentation rate (ESR), versus immunological tests in the assessment of disease activity in systemic lupus erythematosus (SLE).


METHODS
During an evaluation of disease activity indices in SLE, 39 patients had a full clinical evaluation in 99 visits including a disease activity index (MEX-SLEDAI), and serial measurements of HR, ESR, CBC, complement (C3, C4) and anti-dsDNA antibody levels (Farr).


RESULTS
Resting HR exhibited the highest correlation with MEX-SLEDAI scores (rs = 0.62). Thus, the disease was active (MEX-SLEDAI score of 2 or more) in all but one of 15 patients (93.3%) that had an HR > 90/min during the study. Hemoglobin levels (Hb) and ESR showed the second highest correlation (rs = -0.51, and 0.50, respectively). Seventeen patients had an Hb < 13 g/dl at least once; 14 (82.4%) had active disease during the study. Lymphocyte count, C3 levels, and anti-dsDNA levels correlated less strongly with disease activity (rs = -0.27, -0.29, and 0.30 respectively). Forward stepwise multiple regression analysis showed that HR, Ht, and C3 were independent markers of disease activity in this population (R2 = 0.51, p < 0.0001).


CONCLUSIONS
Closer attention to resting HR and CBC results may improve the assessment of disease activity in SLE.
Department of Immunology and Rheumatology, Instituto Nacional de la Nutrición Salvador Zubirán, México DF, México.
J
J
Guzmán
M H
MH
Cardiel
A
A
Arce-Salinas
D
D
Alarcón-Segovia
D000293:Adolescent; D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D001772:Blood Cell Count; D001799:Blood Sedimentation; D003176:Complement C3 / Q000032:analysis; D003181:Complement C4 / Q000032:analysis; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012146:Rest / Q000502:physiology; D012720:Severity of Illness Index
D000974:Antibodies, Antinuclear; D003176:Complement C3; D003181:Complement C4