Clinical Characteristics And Risk Factors Of Cardiac Involvement In Systemic Lupus Erythematosus

Objective:To investigate the clinical features and possible risk factors of cardiac involvement in systemic lupus erythematosus(SLE)for better identification,diagnosis and treatment of the disease.Methods:The clinical data of SLE patients admitted to Shenzhen People's Hospital from 2014.10 to 2018.10 were retrospectively collected and analyzed.Cardiac involvements in SLE patients were diagnosed by electrocardiogram(ECG)or/and ultrasonic cardiogram(UCG).SLE with cardiac involvement were classified according to corresponding criteria.Then total SLE were divided into two groups:SLE with cardiac involvement(case group)and SIE without cardiac involvement(control group).Clinical and experimental indicators of the cardiac involvement in SLE patients and the relevant risk factors were statistical by analyzed with SPSS 20.0 software.P values and 95%confidence intervals were used to explore the risk factors for the occurrence of cardiac damage.Results:(1)Total 196 SLE patients were enrolled,including 187 females and 9males.There were 127 cases(64.8%)of SLE patients with cardiac involvement,but only 30(23.6%)of them had obvious clinical symptoms.The average age of these patients was 33.1±8.9 years and the average course of disease was 48.8±54.4 months.(2)The abnormal performance included valvular lesion(87 cases,68.5%),pericardial effusion(75 cases,59.1%),myocardial lesion(60 cases,47.2%),pulmonary hypertension(30 cases,23.6%),arrhythmia(36 cases,28.3%),ST segment and/or T wave(ST-T)ischemic change(25 cases,19.7%).Mitral regurgitation ranked first in valvular lesion(63 cases,49.6%).(3)Univariate analysis showed that clinical indicators such as age(u=2.514,P=0.012),pleurisy(?~2=4.207,P=0.040),lupus nephritis(?~2=4.201,P=0.040),axillary or mediastinal lymphadenopathy(?~2=5.130,P=0.024),laboratory indicators such as total cholesterol levels(u=2.249,P=0.040),complement3(t=2.019,P=0.040)and anti-SSB(?~2=4.485,P=0.040)were identified with significant difference(P<0.05).(4)Compared to the control group,there were more active patients in the case group(?~2=4.676,P=0.031).(5)Multivariate analysis showed that lymphadenopathy(P=0.011),low complement3(P=0.006),anti-SSB(P=0.035)and SLEDAI?10(P=0.012)were risk factors of SLE patients with cardiac involvement.(6)Pericardial effusion,arrhythmia and ST-T changes may be associated with anti-SSB antibodies of SLE patients.Conclusion:1.Cardiac involvements are common in SLE patients,however most patients with cardiac lesions are asymptomatic;2.The most common abnormality in SLE with cardiac involvement is valvular lesions,followed are pericardial effusion and myocardial lesion;3.Lymphadenopathy,Low complement3,positive anti-SSB and SLEDAI?10 were risk factors for SLE patients with cardiac involvement;4.Pericardial effusion,arrhythmia and ST-T changes may be associated with anti-SSB antibodies of SLE patients.5.Performances of ECG,UCG,Chest CT,testing complement,anti-SSB,and the evaluation of SLEDAI score are recommended in patients with SLE,which help the early detection heart involvement in SLE.