DOPPLER ECHOCARDIOGRAPHIC EVALUATION OF LEFT-VENTRICULAR DIASTOLIC FUNCTION IN PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS

Subclinical myocardial involvement frequently occurs in patients with systemic lupus erythematosus (SLE). In this study, left ventricular diastolic function was assessed in 58 patients (54 female and 4 male; mean age 32 ± 11 years) and in 40 sex-matched and age-matched healthy control subjects (37 female and 3 male; mean age 33 ± 9 years) by means of pulsed Doppler echocardiography. All subjects had no clinical evidence of overt myocardial disease or abnormal left ventricular systolic function. Compared with the control group, patients with SLE had significantly prolonged isovolumic relaxation time (62 ± 12 vs 80 ± 14 msec; p < 0.01), reduced peak early diastolic flow velocity (peak E) (82 ± 18 vs 76 ± 16 cm/sec; p < 0.05), increased peak late diastolic flow velocity (peak A) (45 ± 7 vs 53 ± 8 cm/sec; p < 0.01), reduced E/A ratio (1.81 ± 0.32 vs 1.46 ± 0.29; p < 0.001), and lower deceleration rate of early diastolic flow velocity (EF slope) (489 ± 151 vs 361 ± 185 cm/sec2; p < 0.05). Subgroup analysis according to disease activity revealed that when compared to the inactive disease group, the active disease group had significantly longer isovolumic relaxation time (74 ± 21 msec vs 92 ± 18 msec; p < 0.01), lower peak E (78 ± 16 vs 70 ± 16 cm/sec; p < 0.05), higher peak A (51 ± 8 vs 57 ± 7 cm/sec; p < 0.01), lower E/A ratio (1.56 ± 0.25 vs 1.26 ± 0.27; p < 0.001) and lower EF slope (379 ± 169 cm/sec2 vs 324 ± 172 cm/sec2; p < 0.05). In conclusion, an abnormal pattern of left ventricular diastolic filling dynamics occurs in patients with SLE. These abnormalities may represent myocardial involvement in SLE and may be related to disease activity. © 1990.