Background:Systemic lupus erythematosus (SLE) is a chronic and autoimmune disease characterized by systemic involvement. Patients with SLE have accelerated atherosclerosis, resulting in an up to nine-fold increased risk of cardiovascular disease, compared to the general population (1), being the leading cause of death for these patients. Speckle tracking echocardiography (STE) is an accurate technique to estimate myocardial function and deformation.Objectives:This study aims to determine the association between echocardiographic findings and the presence of antibodies in SLE patients.Methods:This was a cross-sectional and observational study. A total of forty-three patients ≥18 years with a diagnosis of SLE according to EULAR/ACR 2019 criteria were included for this study. Those with a history of cardiovascular disease (myocardial infarction, cerebrovascular accident, or peripheral arterial disease) and pregnancy were excluded. Transthoracic echocardiogram was performed and reviewed by 2 board-certified cardiologists, in all study subjects. Blood samples obtained from all patients were analyzed for the following: anti-nuclear antibodies (ANA), anti, SSA/Ro, SSB/La antibodies, anti-cardiolipin antibodies (IgA, IgM, IgG), and complement levels. Distribution was evaluated with the Kolmogorov-Smirnov test. Correlations between numerical variables were done using Spearman’s rho, considering two-tailed p-values <0.05 as statistically significant.Results:The 39 female patients (90.7%) and 4 male patients (9.3%) had a mean age of 35.5 ± 12.0 years and a median disease duration of 72 months (14-132). At the time of inclusion, 90.7% of the patients were being treated with glucocorticoids and antimalarials. Concerning traditional cardiovascular risk factors; 20.9% of the patients had hypertension, 7.0% had dyslipidemia, 2.3% had diabetes mellitus and 18.6% were active smokers. Correlations between echocardiographic findings and antibodies are shown in Table 1. We found a moderate positive correlation between global circumferential strain and IgA anticardiolipin antibody (r=0.507, p=0.002), a low positive correlation in left ventricular ejection fraction with anti-Ro (r=0.397, p=0.012) and anti-La (r=0.397, p=0.012) and a low positive correlation between TAPSE and C3 levels (r=0.396, p=0.013).Conclusion:There is an association between anticardiolipin antibody titers, anti-Ro, and anti-La with echocardiographic alterations. All SLE patients especially those who had positive antibodies should be screened for the presence of structural cardiac abnormalities. STE can be helpful as a noninvasive diagnostic tool, that could result in earlier treatment and prognosis.References:[1]Hesselvig JH, Ahlehoff O, Dreyer L, et al. Cutaneous lupus erythematosus and systemic lupus erythematosus are associated with clinically significant cardiovascular risk: a Danish nationwide cohort study. Lupus 2017;26(1):48-53. doi: 10.1177/0961203316651739Table 1.Spearman rho correlations between antibody titers and echocardiographic findings.VariablesGLS,mean ± SD-19.11 ± 3.33LVEF,mean ± SD57.43 ± 7.17TAPSE,mean ± SD22.23 ± 3.24ANA, median (p25-p75)640 (160-2550)NSNSNSIgA Anti-Cardiolipin, median (p25-p75)2 (2-3)0.507**NSNSIgM Anti-Cardiolipin, median (p25-p75)2 (2-4)NSNSNSIgG Anti-Cardiolipin, median (p25-p75)4 (3-6)NSNSNSAnti-Ro, median (p25-p75)17 (2-80)NS0.326*NSAnti-La, median (p25-p75)3 (2-5.5)NS0.397*NSC3, mean ± SD91.41 ± 37.38NSNS0.396***Correlation is significant at the 0.01 level (2-tailed). *Correlation is significant at the 0.05 level. NS, not significant; GLS, global circumferential strain; LVEF, left ventricular ejection fraction; TAPSE, tricuspid annular plane systolic excursion.Disclosure of Interests:None declared
Antibodies to sm in patients with systemic lupus erythematosus. correlation of sm antibody titers with disease activity and other laboratory parameters