Echocardiography in systemic lupus erythematosus

Two dimensional echocardiography with doppler examination was performed in 54 patients with systemic lupus erythematosus (SLE). Nine (17%) had signifi cant cardiac involvement (four left ventricular hypertrophy, one moderate p ericardial effusion, one severe aortic regurgitation, and three ventricular systolic dysfunction). We further studied diastolic function in 45 patient s who did not have a major abnormality in echo. SLE was graded as active in 16 patients (SLEDAI > 5) and inactive in 29 patients. Twenty age- and sex- matched subjects acted as controls. The data were compared using one way AN OVA test. Patients with active disease had significant diastolic dysfunctio n compared to inactive patients and controls as indicated by increased peak A (P < 0.01) and decreased E/A ratio (P < 0.01). There was no linear corre lation between disease activity and diastolic dysfunction if SLEDAI was con sidered as a continuous variable (r=0.29 for E/A). Anticardiolipin antibodi es (both IgG and IgM) were elevated in five patients (13 studied). One of t hem had severe mitral regurgitation, one had trace mitral and aortic regurg itation and one had diastolic dysfunction. We conclude that asymptomatic diastolic dysfunction is present in SLE patie nts.