Evaluation of left ventricular myocardial function in Egyptian patients with systemic lupus erythematosus: Tissue Doppler study and its relation to disease activity

Systemic lupus erythematosus (SLE) is associated with high cardiovascular morbidity and mortality. It is frequently underestimated by routine imaging techniques. Aim of the work was to determine if new echocardiographic imaging modalities like tissue Doppler, can detect abnormalities in left ventricular function in asymptomatic SLE patients. Fifty SLE patients were attending the rheumatology department of the Kasr El Aini hospital. All patients were subjected to cardiac, musculoskeletal examination, routine laboratory investigations. Twenty healthy age matched subjects were taken as controls. Ultrasound examination by two dimensional echocardiography and color tissue Doppler were performed on the patients and control to obtain the cardiac chamber diameters, systolic and diastolic myocardial velocities. SLE patients have an increased prevalence of subclinical LV dysfunction. SLE patients with positive tissue Doppler findings were of old age, had long disease duration, high disease activity and nephritis. Tissue Doppler velocities have been shown to be a sensitive tool in detecting early myocardial dysfunction before the occurrence of reduced left ventricular ejection fraction (LVEF).