Background:
Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease affecting multiple organs including the heart, which when affected portends poor prognosis. Given the advances in therapies and vigilance for cardiovascular screening for SLE patients, we evaluated the contemporary cardiovascular characteristics, manifestations and outcomes in SLE patients at our tertiary referral center.
Methods:
Consecutive patients from the prospective SLE bio-repository at our center between October 2012 and March 2020 were included. Cardiovascular data pertaining to manifestations, investigations, management and outcomes were collected.
Results:
258 SLE patients were studied, with mean age 42.2 ± 14.7 years and 233 (90.3%) females. Cardio-respiratory symptoms were present in 92 (35.7%), most commonly dyspnea in 62 (24.0%) and chest pain in 53 (20.5%). Cardiac manifestations occurred in 97 (37.6%) patients, with pericardial disease in 38 (14.7%), valvular disease in 20 (7.8%), stroke/transient ischemic attack in 20 (7.8%), coronary heart disease in 17 (6.6%) and heart failure hospitalizations in 13 (5.0%) (Table 1). During a mean follow-up of 3.0 ± 2.2 years, there were 5 (1.9%) deaths, 19 (7.4%) developed cardiac events (table 1), 6 (2.3%) had cardiovascular procedures (3 cardiac surgeries, 2 percutaneous interventions and 1 device), and 44 (17.1%) had SLE-related hospitalizations.
Conclusion:
Cardiac manifestations remain prevalent in SLE, especially for pericardial, valvular and atherosclerotic diseases. With appropriate contemporary SLE and cardiovascular management, subsequent medium term adverse cardiovascular outcomes are low.
Assessment of pericardial disease by magnetic resonance and computed tomography
