Left ventricular size and function in patients with systemic lupus erythematosus associate with lupus anticoagulant : An echocardiographic follow-up study
Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved..
BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with increased risk of cardiac dysfunction. The pathophysiological mechanisms are poorly understood, and prognostic markers are warranted.
PURPOSE: We aimed to identify SLE-characteristics associated with measures of cardiac size and function during a five-year follow-up.
METHODS: We included 108 patients with SLE: 90% females, mean age 46 ± 13 years, median disease duration 14 (range 7-21) years. We performed blood sampling for potential biomarkers as well as a standard echocardiography at baseline and at a 5-year follow-up. To investigate associations with baseline and prospective 5-year changes in echocardiographic parameters, we performed multivariate regression analyses of SLE-related baseline variables (clinical disease activity, lupus nephritis, chronic kidney disease, anti-cardiolipin and/or anti-beta-2 glycoprotein I antibodies, and lupus anticoagulant (LAC)) and adjusted for traditional risk factors.
RESULTS: During follow-up, diastolic function regressed in two out of five echocardiographic measures (E/A ratio 1.4 ± 0.5 vs. 1.3 ± 0.5, p = 0.002; tricuspid regurgitation peak velocity 2.0 ± 0.6 vs. 2.2 ± 0.4 mmHg, p < 0.001). Left ventricular (LV) end-diastolic volume index increased (43.7 ± 13.9 vs. 52.5 ± 15.7 mL/m2, p < 0.001). Left and right ventricular systolic function remained stationary. LAC was associated with inferior diastolic function: lower E/A ratio (p = 0.04) and higher E/e' ratio at baseline (p = 0.04) and increased left ventricular atrial volume index during follow-up (p = 0.01). LAC was further associated with LV dilatation during follow-up (p = 0.01).
CONCLUSION: Presence of LAC was associated with measures of diastolic function as well as progressive LV dilatation during the 5-year follow-up. Thus, LAC might be a predictor of cardiac dysfunction in SLE patients. LAC is known to have implications for the microvascular circulation, but the clinical significance of the present findings is yet to be elucidated.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:132 |
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| Enthalten in: |
Journal of autoimmunity - 132(2022) vom: 01. Okt., Seite 102884 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Myhr, Katrine A [VerfasserIn] |
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| Links: |
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| Themen: |
Diastolic dysfunction |
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| Anmerkungen: |
Date Completed 22.11.2022 Date Revised 30.11.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jaut.2022.102884 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM345471636 |
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| 100 | 1 | |a Myhr, Katrine A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Left ventricular size and function in patients with systemic lupus erythematosus associate with lupus anticoagulant |b An echocardiographic follow-up study |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 30.11.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with increased risk of cardiac dysfunction. The pathophysiological mechanisms are poorly understood, and prognostic markers are warranted | ||
| 520 | |a PURPOSE: We aimed to identify SLE-characteristics associated with measures of cardiac size and function during a five-year follow-up | ||
| 520 | |a METHODS: We included 108 patients with SLE: 90% females, mean age 46 ± 13 years, median disease duration 14 (range 7-21) years. We performed blood sampling for potential biomarkers as well as a standard echocardiography at baseline and at a 5-year follow-up. To investigate associations with baseline and prospective 5-year changes in echocardiographic parameters, we performed multivariate regression analyses of SLE-related baseline variables (clinical disease activity, lupus nephritis, chronic kidney disease, anti-cardiolipin and/or anti-beta-2 glycoprotein I antibodies, and lupus anticoagulant (LAC)) and adjusted for traditional risk factors | ||
| 520 | |a RESULTS: During follow-up, diastolic function regressed in two out of five echocardiographic measures (E/A ratio 1.4 ± 0.5 vs. 1.3 ± 0.5, p = 0.002; tricuspid regurgitation peak velocity 2.0 ± 0.6 vs. 2.2 ± 0.4 mmHg, p < 0.001). Left ventricular (LV) end-diastolic volume index increased (43.7 ± 13.9 vs. 52.5 ± 15.7 mL/m2, p < 0.001). Left and right ventricular systolic function remained stationary. LAC was associated with inferior diastolic function: lower E/A ratio (p = 0.04) and higher E/e' ratio at baseline (p = 0.04) and increased left ventricular atrial volume index during follow-up (p = 0.01). LAC was further associated with LV dilatation during follow-up (p = 0.01) | ||
| 520 | |a CONCLUSION: Presence of LAC was associated with measures of diastolic function as well as progressive LV dilatation during the 5-year follow-up. Thus, LAC might be a predictor of cardiac dysfunction in SLE patients. LAC is known to have implications for the microvascular circulation, but the clinical significance of the present findings is yet to be elucidated | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Diastolic dysfunction | |
| 650 | 4 | |a Echocardiography | |
| 650 | 4 | |a Lupus anticoagulant | |
| 650 | 4 | |a Pathophysiology | |
| 650 | 4 | |a Systemic lupus erythematosus | |
| 650 | 7 | |a Lupus Coagulation Inhibitor |2 NLM | |
| 700 | 1 | |a Zinglersen, Amanda H |e verfasserin |4 aut | |
| 700 | 1 | |a Hermansen, Marie-Louise F |e verfasserin |4 aut | |
| 700 | 1 | |a Jepsen, Mathies M |e verfasserin |4 aut | |
| 700 | 1 | |a Iversen, Katrine K |e verfasserin |4 aut | |
| 700 | 1 | |a Ngo, Anh T |e verfasserin |4 aut | |
| 700 | 1 | |a Pecini, Redi |e verfasserin |4 aut | |
| 700 | 1 | |a Jacobsen, Søren |e verfasserin |4 aut | |
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