Echocardiographic altered left atrial volume index associated to serum inflammatory biomarkers in patients with autoimmune diseases

INTRODUCTION: Autoimmune diseases (AD) have significant cardiovascular impact in clinical outcome. Elevated levels of Endothelin-1 (ET-1) and Vascular cell adhesion molecule (VCAM-1) were shown in AD. Given that AD patients often present with altered left atrial volume index (LAVI), we hypothesized a correlation with inflammatory biomarkers. METHODS: In this prospective, cross-sectional study, we evaluated patients with AD, and compared them to control subjects. The measurements of left atrial dimensions, volume, and LAVI were analyzed. Altered LAVI was defined as ˃34 ml/m RESULTS: A total of 246 AD patients, and 44 control subjects were evaluated. The altered LAVI was observed in 3 (6.8%) controls vs 55 (22.4%) AD patients (p˂0.009). The value of Endothelin-1 in AD patients without altered LAVI was 1.7±1.3 ng/ml vs 2.4±1.8 ng/ml in those with altered LAVI (P<0.003). There were 3 (6.2%) subjects with elevated levels of VCAM-1 in controls vs 67 (27.2%) AD patients (p˂0.001). The value of VCAM-1 in AD patients without altered LAVI was 600.5±281.1 ng/ml vs 709.8±329.8 ng/ml in AD patients with altered LAVI (P<0.03). CONCLUSIONS: AD patients who possess altered LAVI have significantly higher levels of Endothelin-1 and VCAM-1. These biomarkers demonstrated moderate sensitivity and specificity, and high negative predictive accuracy of the existence of altered LAVI in AD patients. Elevated levels of ET-1 and VCAM-1 are associated to altered atrial structure and may improve risk stratification and clinical assessment of AD patients with subclinical heart involvement.