Prevalence of cardiac morphological and functional alterations in systemic lupus erythematosus patients with a low disease activity.

Background Cardiac involvement in systemic lupus erythematosus (SLE) is a common complication and is associated with a considerable morbidity and mortality in these patients. As affected individuals often present with subclinical or nonspecific symptoms the betimes confirmation of cardiac manifestations is challenging. Cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE) is the current gold-standard for non-invasive tissue characterization as well as for the evaluation of systolic and diastolic function. In this study we assessed the cardiac morphology and function in SLE patients with low disease activity. Methods We studied twenty-nine SLE patients (3 male, 26 female) fulfilling the SLE diagnostic criteria of the American College of Rheumatology and compared them to thirty agematched healthy volunteers. All patients were in a stable clinical condition and only patients with a low disease activity (SLEDAI Index < 5) were included. All of them received an individually optimized medication. CMR images were acquired on a 1.5 T whole-body MRI (Achieva, Philips Healthcare, Best, The Netherlands) using a 32-element cardiac phased-array coil. Short and long axis views were obtained applying a standard clinical steady-state free-precession sequence and LGE CMR imaging was performed (Gadolinium-DTPA 0.2 mmol/kg body weight, Magnevist, Schering, Berlin, Germany) in 27 patients. Left and right ventricular (LV, RV) end-diastolic and end-systolic volumes (EDV, ESV), stroke volume (SV), ejection fraction (EF) as well as the mitral/tricuspid annular plane systolic excursion (M/TAPSE) and LV wall mass were measured. Results