ASSESSMENT OF CARDIAC CHANGES IN SYSTEMIC LUPUS ERYTHEMATOSUS BY 2D ECHOCARDIOGRAPHY – A TERTIARY CARE CENTRE STUDY

Abstract

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory rheumatologic disease that can affect several organs such as skin, joints, and kidneys. One of the organs reported to be involved in SLE is the heart. It is a multiorgan autoimmune disease associated with high cardiovascular morbidity and mortality that primarily affects young women. Cardiac diseases in lupus may involve the endocardium, myocardium, and pericardium and may be responsible for fatal outcome. Some cardiovascular abnormalities are seen with positive anti Ro/SS-A, anti La/SS-B, anticardiolipin (aCL), and anti-double- stranded DNA (antids DNA). Moreover, endothelial dysfunction was reported in early SLE cases without CVDs which was mostly not related to aCL antibodies, disease activity, or disease duration but rather related to renal disease, diastolic hypertension, and diabetes in SLE. The aim of this study is to assess the cardiac function in systemic lupus erythematosus by 2D echocardiography

Material and Method: This was a cross-sectional, observational type of study done in one year duration from april 2019 to march 2020. Study was done in General medicine OPD, Rheumatology OPD and ward of Department of Medicine, SMS Medical College and attached group of hospitals, Jaipur.

Result: Total of 45 cases and control were studied in this study in one year of duration. Various ECG changes among which 80% patients showed sinus tachycardia followed by 26.67% patients showed LVH strain pattern followed by 11.11% patients showed T wave inversion and 6.67% patients showed low voltage complex. we calculated 2-D ECHO parameter in chest pain, palpitation and dyspnoea in patients of case group. In chest pain cases mitral regurgitation in 58.97% patients, tricuspid regurgitation in 53.85% patients and LVH changes was seen in 38.46% patients. In palpitation cases mitral regurgitation in 57.14% patients, tricuspid regurgitation in 57.14% patients and LVH changes was seen in 28.57% patients. In dyspnoea mitral regurgitation in 58.82% patients, tricuspid regurgitation in 52.94% patients and LVH changes was seen in 41.88% patients.

Conclusion: SLE patients had an increased prevalence of subclinical systolic and diastolic LV and RV dysfunction. This result advocates for regular follow-up and early screening of SLE patients. Accordingly, treatment focused on improving diastolic heart function may have a role in enhancing QoL and improving the prognosis of SLE patients.

Keywords: Systemic lupus erythemtosus, 2D echocardiography, Heart, Palpitation, Chest pain