Date: Sunday, October 21, 2018
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Subclinical myocardial dysfunction has been reported to occur earlyin SLE. The pathogenesis and prognosis of this finding is not clear. The study aims to search for biomarkers of subclinical myocardial dysfunction which may serve for early detection and better understanding of myocardial dysfunction pathogenesis in SLE.
A cross sectional study of 57 consecutive patients with SLE and 18 controls was performed. Demographic, clinical and cardiovascular risk factor data were obtained by questionnaires and review of patient charts. Serum samples were obtained to determine serum soluble ST2 (sST2), CXCL-10 and high sensitivity troponin (hs-troponin) levels. All participants underwent an Echo Doppler study including comprehensive diastolic function assessment.
Cardiovascular risk factors were more frequent in the SLE group including hypertension, hyperlipidemia, chronic renal failure and smoking. SLE disease activity (SLEDAI) positively correlated with sST2, CXCL-10 and hs-troponin levels (p=0.001; p=<0.001; p=0.008, respectively). Disease damage, measured by the SLE damage index (SDI) positively correlated with sST2 and CXCL-10 levels (p=0.002; p< 0.001, respectively). Looking at tissue echo-Doppler, several measures of diastolic dysfunction negatively correlated with log CXCL-10: including E/A; E/e’lateral and E/e’septal (p=0.04, p=0.003, p=0.029, respectively) while E/e’ positively correlated with CXCL 10 (p=0.001). Diastolic dysfunction parameters also correlated with log sST2 levels, a negative correlation was seen with E/e’lateral and a positive correlation was seen with E/e’ (p=0.001, p=0.006 respectively). Systolic dysfunction parameters positively correlated with hs-troponin: LVED, LVES, IVS, LVMASS and LVMASS index (p=0.007, p=0.002, p=0.002, p=0.001, p=0.001 respectively). In a multivariate analysis, log sST2 and log CXCL-10 were significantly different in SLE patients as compared to controls, independent of cardiovascular risk factors (p=0.005; p=0.004 respectively) and independent of each other (p=0.003, p=0.018, respectively).
Soluble ST2 and CXCL-10 levels were found to correlate with disease activity and accrued damage in SLE and may serve as sensitive biomarkers for early detection of diastolic dysfunction, independent of traditional cardiovascular risk factors, supporting the hypothesis that disease activity has an independent role in the development of myocardial dysfunction in SLE.
To cite this abstract in AMA style:Chorin U, Hochstadt A, Levartovsky D, Litinsky I, Elalouf O, Polachek A, Kaufman I, Arad U, Aloush V, Borok Lev-Ran S, Wigler I, Wollman J, Caspi D, Lahat Y, Carmi O, Berliner S, Elkayam O, Topilsky Y, Paran D. Soluble ST2 and CXCL-10 May Serve As Biomarkers of Diastolic Dysfunction in SLE and Correlate with Disease Activity and Damage [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/soluble-st2-and-cxcl-10-may-serve-as-biomarkers-of-diastolic-dysfunction-in-sle-and-correlate-with-disease-activity-and-damage/. Accessed June 7, 2020.
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