Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland.
Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland.
Lupus. 2021 Jun;30(7):1154-1162. doi: 10.1177/09612033211006900. Epub 2021 Apr 15.
Patients with systemic lupus erythematosus (SLE) have a higher risk of myocardial involvement, which can result in ventricular dysfunction. The aim of our study was to estimate potential relationship between exercise capacity assessed by six minute walk test (6MWT) and echocardiographic parameters of left and right ventricular function in SLE patients.
We prospectively studied 66 SLE patients (57 F, age 44 (20-75) years) and 27 age matched healthy subjects. In addition to routine evaluation, 6MWT and transthoracic echocardiography including LV diastolic dysfunction parameters (E/A, E/É) were performed.
While E/A was similar in both groups, E/E' was higher in patients with SLE than in controls, 7.5 (4-22) vs 6.8 (1.6-9.4), p = 0.018. The mean 6MWT distance was significantly shorter in SLE (561.6 ± 150.7 vs 682.6 ± 98.1 m, p < 0.002). Among SLE patients only 53 (80.3%) were capable to walk at least 450 m, while in controls 27 (100%) (p = 0.013). We observed significant correlations between 6MWT distance and SLICC/ACR-DI (rho=-0.44, p < 0.001), E/A (rho = 0.30, p = 0.004), E/E' (rho=-0.36, p < 0.001) in SLE patients. Univariable logistic regression models revealed that SLICC/ACR-DI, E/E', tricuspid regurgitant peak gradient (TRPG), and right ventricular systolic pressure (RVSP) were associated with 6MWT distance lower than < 450 m. ROC curves shown high predictive value of E/E' ratio, TRPG, RVSP in the prediction for 6MWT distance < 450 m.
Impaired exercise tolerance seems to result mainly from the severity of SLE and LV diastolic dysfunction.
红斑狼疮（SLE）患者心肌受累风险较高，可能导致心室功能障碍。本研究旨在评估 6 分钟步行试验（6MWT）评估的运动能力与 SLE 患者左、右心室功能的超声心动图参数之间的潜在关系。
我们前瞻性研究了 66 名 SLE 患者（57 名女性，年龄 44（20-75）岁）和 27 名年龄匹配的健康对照者。除常规评估外，还进行了 6MWT 和经胸超声心动图检查，包括左室舒张功能参数（E/A、E/É）。
两组的 E/A 相似，但 SLE 患者的 E/E'高于对照组，分别为 7.5（4-22）比 6.8（1.6-9.4），p=0.018。SLE 患者的平均 6MWT 距离明显较短（561.6±150.7 比 682.6±98.1 m，p<0.002）。SLE 患者中只有 53 名（80.3%）能够行走至少 450 m，而对照组中有 27 名（100%）（p=0.013）。我们观察到 SLE 患者中 6MWT 距离与 SLICC/ACR-DI（rho=-0.44，p<0.001）、E/A（rho=0.30，p=0.004）和 E/E'（rho=-0.36，p<0.001）之间存在显著相关性。单变量逻辑回归模型显示，SLICC/ACR-DI、E/E'、三尖瓣反流峰值梯度（TRPG）和右心室收缩压（RVSP）与 6MWT 距离<450 m有关。ROC 曲线显示 E/E'比值、TRPG、RVSP 对预测 6MWT 距离<450 m 具有较高的预测价值。
运动耐量受损似乎主要源于 SLE 的严重程度和左室舒张功能障碍。
