scholarly journals Layer‐specific strain and dyssynchrony index alteration in new-onset systemic lupus erythematosus patients without cardiac symptom

2020 ◽  
Author(s):  
Tingting Luo ◽  
Zhenhua Wang ◽  
Zhen Chen ◽  
Ermei Yu ◽  
Chenglong Fang
Keyword(s):  
Disease Activity ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Left Ventricular ◽  
Hscrp Level ◽  
Specific Strain ◽  
Drug Naïve ◽  
Dyssynchrony Index ◽  
Onset Systemic Lupus Erythematosus ◽  
New Onset

Abstract Background Layer-specific speckle-tracking echocardiography (STE) is a noninvasive approach assessing subclinical left ventricular (LV) dysfunction. We aimed to investigate: (I) layer‐specific strain and dyssynchrony index alteration; (II) disease parameters associated with layer-specific STE change; (III) effects of hydroxychloroquine (HCQ) therapy on layer-specific STE parameters in drug-naïve patients with new-onset systemic lupus erythematosus (SLE) without cardiac symptoms. Methods 35 drug-naïve patients with new-onset SLE and 25 age-and-sex-matched healthy controls were enrolled. All individuals received both conventional echocardiographic and two-dimensional STE assessment. Layer-specific global longitudinal strain (GLS), global circumferential strain (GCS) and peak systolic dispersion (PSD) were acquired in layer-specific STE. The effect of HCQ monotherapy on GLS parameters and PSD was assessed in 7 SLE patients with stable disease. Results All patients had normal left ventricular ejection fraction (LVEF). Conventional echocardiographic parameters were comparable between patients and controls. Decreased layer-specific GLS and elevated PSD were observed in SLE patients. In contrast, there’s no difference of layer-specific GCS at the basal level, papillary muscle level and apical level between patients and controls. More severely impaired GLS was observed in patients with higher disease activity, high-risk aPL profile or renal involvement. PSD increased in patients with higher disease activity or high-risk aPL profile. Correlational analysis showed that GLS at three layers and PSD correlated with high-sensitivity CRP (hsCRP) levels. PSD correlated with epicardial GLS, when treating hsCRP level, renal involvement, profile of aPL and disease activity as control variables. Multivariate regression showed hsCRP level and epicardial GLS are the predictors of layer-specific GLS impairment and elevated PSD, respectively. No change of GLS at three layers or PSD was observed in the first 6 months of HCQ treatment, compared with baseline. During the second 6 months of HCQ treatment, increase of endocardial GLS and whole layer GLS, and decrease of PSD were detected. There was no change of epicardial GLS during follow-up. Conclusion Drug-naïve patients with new-onset SLE, even having normal LVEF, are likely to have subclinical GLS impairment and LV dyssynchrony. SLE-related risk factors are associated with these dysfunctions. Continuous use of HCQ may provide beneficial effects to the silent cardiac impairment.

Anti-Smith antibody is associated with disease activity in patients with new-onset systemic lupus erythematosus

2019 ◽  
Vol 39 (11) ◽  
pp. 1937-1944
Author(s):  
Sung Soo Ahn ◽  
Seung Min Jung ◽  
Juyoung Yoo ◽  
Sang-Won Lee ◽  
Jason Jungsik Song ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Onset Systemic Lupus Erythematosus ◽  
New Onset

Early Detection of Silent Myocardial Impairment in Drug‐Naive Patients With New‐Onset Systemic Lupus Erythematosus

2018 ◽  
Vol 70 (12) ◽  
pp. 2014-2024 ◽  
Author(s):  
Qiang Guo ◽  
Lian‐Ming Wu ◽  
Zi Wang ◽  
Jia‐Yan Shen ◽  
Xuan Su ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Early Detection ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Drug Naïve ◽  
Onset Systemic Lupus Erythematosus ◽  
New Onset

scholarly journals POS0685 MYCOPHENOLATE MOFETIL IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS: FIVE-YEARS DRUG SURVIVAL IN RENAL AND NON-RENAL INVOLVEMENT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 588.2-588
Author(s):  
G. Olivieri ◽  
F. Ceccarelli ◽  
F. Natalucci ◽  
F. R. Spinelli ◽  
C. Alessandri ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Mycophenolate Mofetil ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Treatment Duration ◽  
Retention Rate ◽  
Renal Involvement ◽  
Joint Involvement ◽  
Systemic Lupus ◽  
Median Treatment

Background:The updated EULAR recommendations for the management of systemic lupus erythematosus (SLE) underline the use of Mycophenolate Mofetil (MMF) in the treatment of different disease related manifestations (1). Several randomized controlled trials have demonstrated the efficacy of MMF in lupus nephritis (LN) patients but only case series and open-labelled trials have analyzed the use of this drug in other than LN features. Moreover, no data are available about the MMF retention rate in a real-life setting.Objectives:The present study aims at evaluating the 5-years drug retention rate (DRR) of MMF in a large monocentric SLE cohort. Secondly, we investigated the influence of MMF in disease activity changes and chronic damage progression.Methods:We performed a longitudinal study including all the SLE patients (ACR 1997 criteria) starting MMF treatment in our Lupus Clinic. Data about indications, mean dosage, duration of treatment and reasons for drug withdrawal were registered. The DRR was estimated using the Kaplan–Meier method. Disease activity and chronic damage were assessed by SLE Disease Activity Index 2000 (SLEDAI-2K) and SLICC Damage Index (SDI), respectively.Results:The present analysis included 162 SLE patients (M/F 22/140, median age at the disease diagnosis 25.5 years, IQR 13). At the beginning of MMF treatment, we registered a median age of 34 months (IQR 21) and a median disease duration of 72 months (IQR 123). The most frequent indications for prescribing MMF were LN (101 patients, 62.3%) and musculoskeletal manifestations (39, 24.1%), followed by neuropsychiatric involvement (10, 6.2%), and others disease related manifestations (12, 7.4%; in particular skin involvement, hematological features, myositis, vasculitis). MMF was administered at a mean daily dosage of 2.1±0.6 grams; no differences in dosage were found between the different indications (p=ns).At the longitudinal analysis, we registered a median treatment duration of 30 months (IQR 55). Figure 1 reported data about DRR: in particular, at 60 months follow-up we observed a DRR of 61.1% for LN patients, which was similar to that registered for patients without renal involvement (NLN) (60.5%; p=ns). Interestingly, the DRR at 60 months was higher in the subgroup of patients treated for joint involvement (75.4%), even without reaching a statistically significant difference. During the observation period, 92 patients (59.2%) discontinued MMF (median treatment duration at discontinuation 25 months, IQR 35). Interestingly, the main cause of withdrawal was the achievement of persistent remission, observed in 20 patients (21.7%), followed by loss of efficacy (19 patients, 20.5%), drug intolerance and pregnancy planning (17 patients for both reasons, 18,4%). Furthermore, our analysis confirmed MMF efficacy, as demonstrated by the significant reduction in SLEDAI-2k values after 4, 12 and 24 months of treatment (p< 0.0001 for all the time-points in comparison with baseline). In addition, MMF resulted able to control chronic damage progression, as demonstrated by the lack of significant increase in SDI values (baseline: 0.6, IQR 1; last observation: 0.93, IQR 1; p=ns).Conclusion:The evaluation of a large SLE cohort demonstrated a good retention rate for MMF. In particular, our results demonstrated that MMF is also a safe and effective drug for SLE manifestation other than LN, in particular for joint involvement. Moreover, it is able to control disease activity and to prevent the progression of chronic damage.References:[1]Fanouriakis A et al. Ann Rheum Dis. 2019 Jun;78(6):736-745.Disclosure of Interests:None declared

scholarly journals Systemic Lupus Erythematosus with and without Anti-dsDNA Antibodies: Analysis from a Large Monocentric Cohort

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Conti Fabrizio ◽  
Ceccarelli Fulvia ◽  
Perricone Carlo ◽  
Massaro Laura ◽  
Marocchi Elisa ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Clinical Laboratory ◽  
Renal Involvement ◽  
Serum Levels ◽  
Activity Measurement ◽  
Systemic Lupus ◽  
Before And After ◽  
Dsdna Antibodies

Objectives. The anti-dsDNA antibodies are a marker for Systemic Lupus Erythematosus (SLE) and 70–98% of patients test positive. We evaluated the demographic, clinical, laboratory, and therapeutical features of a monocentric SLE cohort according to the anti-dsDNA status.Methods. We identified three groups: anti-dsDNA + (persistent positivity); anti-dsDNA ± (initial positivity and subsequent negativity during disease course); anti-dsDNA − (persistent negativity). Disease activity was assessed by the European Consensus Lupus Activity Measurement (ECLAM).Results. We evaluated 393 patients (anti-dsDNA +: 62.3%; anti-dsDNA ±: 13.3%; anti-dsDNA −: 24.4%). The renal involvement was significantly more frequent in anti-dsDNA + (30.2%), compared with anti-dsDNA ± and anti-dsDNA − (21.1% and 18.7%, resp.;P=0.001). Serositis resulted significantly more frequent in anti-dsDNA − (82.3%) compared to anti-dsDNA + and anti-dsDNA ± (20.8% and 13.4%, resp.;P<0.0001). The reduction of C4 serum levels was identified significantly more frequently in anti-dsDNA + and anti-dsDNA ± (40.0% and 44.2%, resp.) compared with anti-dsDNA − (21.8%,P=0.005). We did not identify significant differences in the mean ECLAM values before and after modification of anti-dsDNA status (P=0.7).Conclusion. Anti-dsDNA status influences the clinical and immunological features of SLE patients. Nonetheless, it does not appear to affect disease activity.

scholarly journals Exposure to Air Pollutants and Disease Activity in Juvenile-Onset Systemic Lupus Erythematosus Patients

2015 ◽  
Vol 67 (11) ◽  
pp. 1609-1614 ◽  
Author(s):  
Elisabeth C. Fernandes ◽  
Clovis A. Silva ◽  
Alfésio L. F. Braga ◽  
Adriana M. E. Sallum ◽  
Lúcia M. A. Campos ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Air Pollutants ◽  
Systemic Lupus ◽  
Juvenile Onset ◽  
Onset Systemic Lupus Erythematosus
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