Background/Purpose: Patients with systemic lupus erythematosus (SLE) and lupus nephritis (LN) are at increased risk of cardiovascular (CV) morbidity and mortality, compared to those without LN due to the additional burden of kidney involvement, inflammation, and potential renal impairment contributing to cardiovascular complications. This elevated risk may be associated to the higher values of left ventricular (LV) mass observed in SLE patients, particularly when compared to age and sex-matched controls. Echocardiographic evaluation is not included in current guidelines for managing CV risk in patients with rheumatic diseases. This study aimed to compare LV mass and other echocardiographic parameters between SLE-patients with and without LN.

Methods: We performed a nested case-control study among the SLE-cohort from our center. This cohort includes patients older than 18 years who fulfill the 2019 EULAR/ACR Classification Criteria for SLE. Patients with LN were matched with patients without LN by age and gender. A transthoracic echocardiogram was performed by two certified echocardiographers blinded to clinical information. Comparisons were done with Chi-square or Fisher’s exact test for qualitative variables, and Student’s T-test or Mann-Whitney’s U-test for quantitative variables. A p-value < 0.05 was considered significant.

Results: A total of 48 SLE patients, 24 with LN and 24 without LN, were included. Both groups were similar regarding age (36.9 vs 36.5, p = 0.873) and prevalence of traditional CV risk factors including type 2 diabetes mellitus, hypertension, dyslipidemia, obesity, and smoking (Figure 1). LV mass index was significantly higher in SLE patients with LN (66.9 g/m² vs 54.8 g/m², p = 0.035) in comparison to those without it. There was no difference regarding other echocardiographic parameters (Table 1).

Conclusion: LV mass measurements were higher in patients with SLE and LN in comparison to patients without LN, regardless of traditional CV risk factors. The consequences of increased LV mass can include an elevated risk of CV events such as heart failure, cardiac arrhythmias, and CV mortality. Further studies are necessary to establish the potential role of echocardiography in the CV assessment of patients with SLE, especially those with LN.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/increased-left-ventricular-mass-index-in-systemic-lupus-erythematosus-patients-with-lupus-nephritis-compared-to-those-without-nephritis/