Objective: To comparatively assess parameters of systolic and diastolic cardiac function in SLE and antiphospholipid syndrome (APS) patients.
Methods: Consecutive patients (N=74) who were free of cardiovascular symptoms were divided into 4 groups: 1) SLE (N=23); 2) SLE with antiphospholipid antibodies (aPL) (N=18); 3) SLE with APS (N=20); 4) Primary antiphospholipid syndrome (PAPS) (N=13). Pulsed, continuous, color Doppler echocardiography, and M- and B- mode studies were performed.
Results: Left ventricular (LV) end diastolic and end systolic dimensions were higher in SLE as compared to PAPS patients (p=0.022; p=0.022, respectively), with a trend toward a lower fractional shortening in SLE (p=0.07), suggesting systolic dysfunction. Parameters of diastolic function were more impaired in APS patients, reflected by lower LV and right ventricular (RV) E/A ratios in APS (groups 3, 4) compared to non-APS patients (groups 1, 2) (1.15+0.40 vs.1.49+0.43, p=0.001 and 1.19+0.31 vs. 1.49+0.41, p=0.001, respectively) and a more prolonged LV isovolumic relaxation time (LVIVRT) (94.2 +24.6 ms vs. 84.4+17.0 ms respectively, p=0.055). APS patients were older than non-APS (47.12+14.86 vs. 34.29+12.6, p=0.0001). SLE patients were younger than PAPS (38.19+14.68 vs. 48.53+13.97, p=0.023).
Conclusion: Abnormal echocardiographic findings were detected frequently in asymptomatic patients with SLE or PAPS. Although SLE patients were younger, LV systolic function was more impaired in SLE compared to PAPS patients while LV and RV diastolic function, as reflected by LVIVRT and E/A ratios, were significantly more impaired in APS patients.
- antiphospholipid syndrome
- systemic lupus erythematosus