title: Echocardiographic findings in asymptomatic systemic lupus erythematosus patients.
abstract: The aim of this study is to use transthoracic echocardiographic (TTE) imaging methods to identify cardiac dysfunction in asymptomatic systemic lupus erythematosus (SLE) patients and to determine the association between echocardiographic findings and serology. This is a prospective cross-sectional study where 50 patients with confirmed diagnoses of SLE were recruited from rheumatology outpatient clinics. Clinical and serological evaluation to confirm the diagnosis of lupus was done in all patients. Fifty SLE patients, 46 (92%) females and 4 (8%) males, were recruited. Anti-double-stranded DNA (Anti-dsDNA), anticardiolipin, lupus anticoagulant, and anti-β2-glycoproteins were positive in 52.1, 32.6, 13.3, and 15.6%, respectively. Transthoracic echocardiogram revealed mitral regurgitation in 16 patients (32%), pericardial effusion in16 patients (32%), aortic regurgitation in five patients (10%), and tricuspid regurgitation in 10 patients (20%). Eleven patients had left ventricular hypertrophy (22%), and eight patients had ventricular systolic dysfunction (16%). Only four patients had ventricular diastolic dysfunction (8%). A significant association between mitral and tricuspid valve regurgitation and positive anti-dsDNA (p < 0.018, p < 0.006, respectively) was found. Positive anticardiolipin antibodies, lupus anticoagulant, and anti-β 2 glycoprotein antibodies were also associated with mitral valve regurgitation (p values 0.044, 0.006, and 0.023), respectively. Active disease assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was found to be associated with increased risk of mitral valvular leaflet thickening (p value 0.028). Performing regular transthoracic echocardiogram in asymptomatic SLE patients is important for early detection and appropriate treatment of cardiac lesions. Clinically quiescent but serologically active disease and presence of antiphospholipid antibodies were associated with structural heart abnormalities.
authors.affiliation: Medical Specialties Department, Rheumatology Section, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525, Kingdom of Saudi Arabia.
authors.forename: Abdel GaffarA
authors.initials: AG
authors.lastname: Mohammed
authors.affiliation: King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia.
authors.forename: Abdulaziz A
authors.initials: AA
authors.lastname: Alghamdi
authors.affiliation: Medical Specialties Department, Rheumatology Section, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525, Kingdom of Saudi Arabia.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: ALjahlan
authors.affiliation: Medical Specialties Department, Rheumatology Section, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525, Kingdom of Saudi Arabia. iaalhomood@kfmc.med.sa.
authors.forename: Ibrahim A
authors.initials: IA
authors.lastname: Al-Homood
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017153:Antibodies, Anticardiolipin / Q000097:blood; D001323:Autoantibodies / Q000097:blood; D002648:Child; D003430:Cross-Sectional Studies; D004247:DNA / Q000276:immunology; D004452:Echocardiography; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D017153:Antibodies, Anticardiolipin; D001323:Autoantibodies; D016682:Lupus Coagulation Inhibitor; D004247:DNA
keywords: Antiphospholipid syndrome (APS); anti-double-stranded DNA (dsDNA); Echocardiogram; Systemic lupus erythematosus (SLE); valve