Department of Internal Medicine, HMPIT, Tunis, Tunisia.
Lupus. 2024 Sep;33(10):1100-1108. doi: 10.1177/09612033241266990. Epub 2024 Jul 23.
Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease of undetermined etiology. Cardiac involvement is common in SLE and constitutes one of the main causes of mortality. More recently, new ultrasound imaging techniques, such as transthoracic ultrasound (TTE) with strain evaluation, have appeared and seem promising for the detection of cardiac involvement. The objective of our work was to study the frequency and characteristics of ultrasound abnormalities found in lupus patients and to study the benefit of ultrasound with global longitudinal strain (GLS) for early management.
It was an observational study of patients followed for SLE at the internal medicine and cardiology department of the HMPIT for 6 months (May-November 2023). The definition of cardiac involvement was by ultrasound. All patients benefited from TTE coupled with 2D-strain. We divided the workforce into two groups: the first group (patients with heart disease) and the second group (patients without heart disease).
In a series of 40 lupus patients including 33 women and seven men, cardiac manifestations were reported in 60% of patients. In the first group, 29% had palpitations, 25% had chest pain, 67% had dyspnea, 37% had pericarditis, 8% had pulmonary arterial hypertension (PAH) and 12% had myocarditis. The comparative study showed that patients in the first group presented significantly more frequently with dyspnea ( = 0.02), chest pain ( = 0.03) and serositis ( = 0.01) compared to those in the second group. The mean left ventricular ejection fraction (LVEF) did not show a significant difference between the two groups. On the other hand, the average Global Longitudinal Strain (GLS) was significantly altered in the first group ( = 0.01). Furthermore, the frequency of pathological GLS was significantly higher in patients with lupus heart disease ( < 0.01).
Cardiac involvement during SLE is a frequent and most often asymptomatic complication. A systematic search for this impairment using a high-performance echocardiography examination, namely the 2D GLS, is essential for early treatment.
系统性红斑狼疮（SLE）是一种病因不明的慢性多系统自身免疫性疾病。心脏受累在 SLE 中很常见，是导致死亡的主要原因之一。最近，出现了新的超声成像技术，如经胸超声（TTE）联合应变评估，似乎对心脏受累的检测具有很大的潜力。我们的工作目的是研究狼疮患者中超声异常的发生率和特征，并研究超声整体纵向应变（GLS）对早期管理的益处。
这是一项观察性研究，纳入了 2023 年 5 月至 11 月在 HMPIT 内科和心脏病科就诊的 SLE 患者。心脏受累的定义是通过超声检查。所有患者均接受了 TTE 联合 2D 应变检查。我们将患者分为两组：第一组（有心脏病的患者）和第二组（无心脏病的患者）。
在一组 40 例狼疮患者中，包括 33 名女性和 7 名男性，有 60%的患者出现了心脏表现。在第一组中，29%的患者有心悸，25%的患者有胸痛，67%的患者有呼吸困难，37%的患者有心包炎，8%的患者有肺动脉高压（PAH），12%的患者有心肌炎。比较研究显示，与第二组相比，第一组患者呼吸困难（ = 0.02）、胸痛（ = 0.03）和浆膜炎（ = 0.01）的发生率显著更高。两组间的左心室射血分数（LVEF）平均值无显著差异。另一方面，第一组的平均整体纵向应变（GLS）明显改变（ = 0.01）。此外，狼疮性心脏病患者病理性 GLS 的发生率显著更高（ < 0.01）。
SLE 期间的心脏受累是一种常见且通常无症状的并发症。使用高性能超声心动图检查（即 2D GLS）系统地寻找这种损伤对于早期治疗至关重要。
