SAT0202\u2005EVALUATION OF LEFT ATRIAL MYOCARDIAL DEFORMATION AS MARKER OF SUBCLINICAL DAMAGE IN PATIENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

Background The left ventricle diastolic dysfunction (LVDD) may be the only manifestation of cardiac involvement in patients with systemic lupus erythematosus (SLE), preceding systolic dysfunction. The myocardial deformation of left atrium (LA) through the evaluation of LA global longitudinal strain (LALS) may be useful in assessing diastolic function since the lower the LALS the worse is the diastolic function. Objectives The main objective of this study was to evaluate the LA function through myocardial deformation by strain and strain rate derived from speckle tracking echocardiography in patient with SLE without any cardiovascular symptoms and compare with Control Group (CG). To compare LA strain of patients with active, inactive SLE disease and control group and determinate the independent factors associated with depressed LALS. Methods A cross sectional study was performed. Fifty patient that fulfilled 2012 SLICC classification criteria for SLE were included and they were compared with fifty age- and gender -matched healthy subjects as control group. Myocardial deformation was measured by transthoracic echocardiogram, performed by a board-certified echocardiographer, to investigate the LALS, the strain of the three phases of the LA cycle and the strain rate. SLE disease activity was defined as a Mexican version of the Systemic Lupus Erythematosus Disease Activity Index (Mex-SLEDAI) ≥9 and SLE-related organ damage as SLICC/ACR damage Index (SDI) ≥1. Descriptive statistics with mean and standard deviation or median and Interquartile range were calculated and categoric variables were expressed as proportions. Chi-squared test was done to compare categoric variables; quantitative variables were compared with student’s t test. ANNOVA test was used to evaluated differences among multiple groups. A univariate linear regression analysis was performed to determinate de independent factors associated with LAGLS less than thirty five percent. Results 90% of patients were females and their mean age was 34 (±12) years old. 16% of patients had positive antiphospholipid antibodies. The mean MEX-SLEDAI was 8.7 (±5) and the mean SDI was 0.7 (±0.3). The mean of disease duration was 6 years. The patients with SLE had greater diastolic disfunction evaluated with conventional echocardiography compared with CG (E/e’Ratio of 7.9 (±2.6) vs 6.4 (±1.8), p=0.001) (left atrial volume index (LAVI) of 26.1 mL/m2 (±8.8) vs 20.7mL/m2 (±4.4), p<0.001). SLE patients had significant impaired of LALS compared with CG (41.6% vs 50.5%; p=0.02). As well in the 3 phases of the LA cycle. Also, the LALS was significantly lesser in patients with active disease than inactive and CS (36.3% (25.3-54.3) vs 43% (35.2-52.6) vs 50.5% (41.7-70.6)). The positivity of antiphospholipid antibodies, lupus nephritis, glucocorticoids use, and the presence of disease activity were significant independent factors for depressed LALS in the univariate analysis. Conclusion SLE patients have lower myocardial deformation of the LA, which is expressed as a lower diastolic function correlating with early subclinical myocardial damage. References [1] Dai M, Li KL, Qian DJ, Lu J, Zou YH, Cao YX, et al. Evaluation of left atrial function by speckle tracking echocardiography in patients with systemic lupus erythematosus. Lupus.2016;25(5):496-504 [2] Li K, Wang R, Dai M, Lu J, Zou Y, Yang X. Evaluation of Left Atrial Function by Real-time 3-D Echocardiography in Patients with Systemic Lupus Erythematosus. The Journal of Rheumatology.2015;42(2):196-201. Disclosure of Interests None declared