Risk Factors Of Cardiac Involvement In Systemic Lupus Erythematosus

Objective:To analyze the incidence and clinical characteristics of systemic lupus erythematosus(SLE) with cardiac involvement and to investigate the risk factors of it.Methods:Medical records of159SLE patients hospitalized from2009.1to2012.1in second affiliated hospital Zhejiang university college of medicine were retrospectively analyzed.Results:1.102cases had cardiac involvement out of159patients and only5had cardiac symptoms(3.1%). The manifestations were numerous,including arrhythmia in36cases(35.3%), ischemic changes ST segment and/or T wave(ST-T) in22cases(21.6%),pericardial effusion in32cases(31.4%),valvular disease in47cases(46.1%),myocardal lesions in38cases(37.3%) and ulmonary hypertension in29cases(28.4%);2.The comparision on age and course of diseasebewteen patients with cardiac invovlement and those without it:The patients with cardiac involvement had no significant differences in age and course of disease comparing to those without it (P>0.05),but patients with myocardial lesions were older than those without(P<0.05). Patients with and without cardiac block differ significantly in disease course (P<0.05).3. The compariation on the laboratory characteristics bewteen cardiac invovlement and those without it: The patients with cardiac involvement had no significant differences in autoantibodies, immunoglobulin, complement4comparing to those without(P>0.05),but the complement3in patients with ischemic changes ST segment and/or T wave, arrhythmia and valvular disease was lower than those without (P<0.05);compared with those without cardiac involvement, LDH in patients with pericardial effusion, arrhythmia and cardiac block was higher (P<0.05);4. The connection between cardiac involvement and anti-SSA/SSB antibody in SLE patients:There were no significant differences of incidence of cardiac involvement between patients with positive anti-SSA/SSB antibody and those with negative value;5. The correction between cardiac involvement and anticardiolipin(ACL) antibodies in SLE patients:The difference in incidence of cardiac involvement between patients with positive ACL and those with negative outcome was not significant. Significant differences were found in pericardial effusion, valvular disease and pulmonary heypertension between the group with positive ACL and that with negative outcome(P<0.05).Conclusion:SLE complicated cardiac involvement in SLE is common,with valvular disease the most frequent among the cardiac manifestations.Most patients with cardiac lesions were asymptomatic. ST segment and/or T wave, arrhythmia and valvular disease in SLE were related with decrease complement3.There was association correction between increased LDH and pericardial effusion, arrhythmia and cardiac block.Those with older age were at higher risk of developing myocardial lesions,those with longer course of disease were at higher risk of cardiac block,and those with positive ACL were liable to have pericardial effusion, valvular disease and pulmonary heypertension.