Relation between Heart Valves Calcification and Carotid Atherosclerosis in Systemic Lupus Erythematosus

Objectives: Detection of releation between heart valves calcification and carotid intima-media thickness as predictors of premature atherosclerosis in patients with SLE.Methods: 40 pre menopausal women 28.57±8.24 (18-46) years with SLE satisfying the updated revised criteria for the classification of SLE, were included in the study.Traditional risk factors for atherosclerosis and disease-related factors as disease duration and duration of steroid therapy were recorded. Patients were subjected to carotid Duplex assessment and echocardiography examination.Results: IMT was increased in 27 (67.5%) patients, with relatively younger age of onset (mean age 28.57±8.24 years), a significant positive correlation between thickened IMT and age, duration of disease, duration of steroid therapy, total cholesterol level, triglycerides level (p-value 0.05 ) (r-value= 0.6, 0.63, 0.68, 0.35, 0.04, 0.36 respectively).Prevalence of mitral valve leaflet calcification was (77.7%), mitral annular calcification was (47.5%), aortic valve calcification was (87.5%).Thickened IMT was present in 21 patient (67.7%) with mitral valve leaflet calcification, 13 patient (68.4%) with mitral annular calcification, 25 patient (71.4%) with Aortic valve calcification and in 12 patient (70.6%) with both mitral and aortic calcification but these associations were statistically insignificant (p-value 0.05 ).Conclusion: Increased IMT in SLE patients is associated with disease-related risk factors, disease duration, duration of steroid therapy. High prevalence of heart valves calcification in SLE indicate that SLE is a significant risk factor for premature LV valve calcification.There was no statistically significant correlation between increased IMT and valve calcification, this may be due to smaller size of our sample and relatively younger age of our patients.