Cardiac Involvement in Systemic Lupus Erythematosus: Echocardiographic Evaluation

Background: Cardiac involvement is common and usually silent in patients with systemic lupus erythematosus (SLE). Echocardiography can be a valuable diagnostic method for the detection of cardiac diseases in such patients. We sought to determine the frequency of the different types of cardiac conditions detected by echocardiography in SLE. Methods: In this analytic cross-sectional study, 50 patients with SLE were consecutively included. The patients underwent transthoracic 2D, color Doppler, and tissue Doppler imaging echocardiography. Results: Left ventricular (LV) systolic dysfunction was diagnosed in 9 (18%) patients and LV diastolic dysfunction was seen in 8 (16%). Tricuspid regurgitation (TR) was the most common valvular disease in that it was diagnosed in 29 (58%) patients, followed by mitral regurgitation (MR), detected in 27 (54%) patients. Six (12%) patients had regional wall motion abnormalities. Pulmonary artery hypertension was seen in 25 (50%) patients. Conclusions: Valvular diseases, especially MR and TR, were common among our patients with SLE. Further, LV systolic and diastolic dysfunction was detected in about one-fifth of the patients. As cardiac involvement was common, we think that future studies should focus on 2 issues: firstly, long-term prognosis of subclinical echocardiographically-detected cardiac diseases and secondly, introduction of screening echocardiography into the routine care of patients with SLE.