Division of Cardiology The Chinese University of Hong Kong, Hong Kong, China.
Lupus. 2012 Sep;21(10):1057-62. doi: 10.1177/0961203312446628. Epub 2012 May 3.
Left ventricular (LV) diastolic dysfunction has been reported in both active and inactive systemic lupus erythematosus (SLE) patients without clinical evidence of cardiovascular disease. However, the relationship between the long-term inflammatory burden reflected by the SLICC/ACR damage index and LV diastolic function has not been studied. Eighty-two SLE patients and 82 controls matched for age, sex, body mass index, blood pressure and heart rate underwent echocardiography with tissue Doppler imaging (TDI). LV diastolic function was estimated by the myocardial early diastolic velocity (E') at the lateral annulus. There were 51 patients (62.2%) with nephritis, 23 patients (28.0%) with hypertension, 21 patients (25.6%) with vasculitis, 16 patients (19.5%) with pulmonary hypertension, 4 patients (4.9%) with cerebrovascular disease and 2 patients (2.4%) with diabetes mellitus. Sixty-two patients (75.6%) were taking prednisone and 35 patients (42.7%) used a immunosuppressant. Forty-five patients (54.8%) had active disease and suffered from disease-related end-organ damage. Patients with SLICC/ACR damage index ≥1 had more evidence of LV diastolic dysfunction with lower lateral annulus E' (9.6 ± 3.4 vs 12.9 ± 3.5 cm/s, p < 0.001) than those without. In addition, the proportion of patients with abnormal LV myocardial relaxation (defined as lateral E' < 10.0 cm/s) (51.1% vs 16.2%, χ(2) = 10.8, p = 0.001) were significantly higher. Multivariate analysis showed that the SLICC/ACR damage index ≥1 was independently associated with LV diastolic dysfunction (OR = 3.80, 95%CI: 1.21-11.95, p = 0.023) after adjusting for hypertension, disease duration and medical therapy. This may suggest that the overall inflammatory burden in SLE, as reflected by SLICC/ACR damage index, is associated with the development of diastolic dysfunction in SLE patients.
左心室（LV）舒张功能障碍已在有或无心血管疾病临床证据的活动性和非活动性系统性红斑狼疮（SLE）患者中报道。然而，SLICC/ACR 损伤指数所反映的长期炎症负担与 LV 舒张功能之间的关系尚未得到研究。82 例 SLE 患者和 82 例年龄、性别、体重指数、血压和心率匹配的对照者接受了组织多普勒成像（TDI）的超声心动图检查。通过外侧瓣环的心肌早期舒张速度（E'）来估计 LV 舒张功能。有 51 例（62.2%）患者患有肾炎，23 例（28.0%）患者患有高血压，21 例（25.6%）患者患有血管炎，16 例（19.5%）患者患有肺动脉高压，4 例（4.9%）患者患有脑血管病，2 例（2.4%）患者患有糖尿病。62 例（75.6%）患者服用泼尼松，35 例（42.7%）患者使用免疫抑制剂。45 例（54.8%）患者患有活动性疾病，且患有与疾病相关的终末器官损伤。SLICC/ACR 损伤指数≥1 的患者外侧瓣环 E'较低，提示 LV 舒张功能障碍更明显（9.6±3.4 比 12.9±3.5cm/s，p<0.001）。此外，异常 LV 心肌松弛（定义为外侧 E'<10.0cm/s）患者的比例也明显更高（51.1%比 16.2%，χ(2)=10.8，p=0.001）。多变量分析显示，在校正高血压、疾病持续时间和药物治疗后，SLICC/ACR 损伤指数≥1 与 LV 舒张功能障碍独立相关（OR=3.80，95%CI：1.21-11.95，p=0.023）。这可能表明，SLE 中 SLICC/ACR 损伤指数所反映的整体炎症负担与 SLE 患者舒张功能障碍的发生有关。
