Background/Purpose:

Cardiac block in neonatal lupus is associated with placental transfer of anti-Ro antibodies. The effect of these antibodies on cardiac conduction disorders in adult patients is controversial. Association between anti-Ro antibodies and heart rhythm disorders have been described in isolated cases. However, there are just a few studies that analyse the relationship between autoimmune diseases and electrocardiographic disturbances. Our aim is to determine if there are differences in cardiac conduction of SLE patients in presence of anti-Ro antibodies.

Methods:

All patients included fulfilled the SLE criteria (SLICC 2012) and were followed up in a single centre. Patients taking drugs that alter cardiac conduction (except antimalarial drugs) and those who had heart or thyroid disease were discarded. All patients were assessed blindly by a cardiologist who performed an interrogation and physical examination, an electrocardiogram, an echocardiogram and a 24-hour Holter study. Besides, a rheumatologist performed a clinical and analytical assessment including a qualitative analysis by immunoblotting of anti-Ro Ab and a quantification by chemiluminescence of the anti-Ro52 and Ro60 Ab. The presence of other SLE specific Ab (ANA, DNA, antiphospholipid) was also analysed by immunoblot, indirect immunofluorescence and ELISA. Clinical, analytical activity and damage indexes were collected (SLEDAI and SLICC).

Results:

145 patients were included: 92% women, mean age 45±2, average disease duration 11 years. Patients were undergoing the following treatments: antimalarial 91%, mycophenolate 20%, azathioprine 12%, biological treatment 5% and glucocorticoids 70%. The clinical characteristics are summarized in table 1.

There were no significant differences between positive and negative anti-Ro Ab in terms of gender, age, clinical characteristics or cardiovascular risk factors. None of the patients was affected by an atrio-ventricular block and the rest of the electrocardiographic alterations had no clinical significance and did not predominate in the positive Ro Ab group. Additionally, no differences in heart rate, ventricular extrasystoles or PR, QT or QRS intervals were detected between both groups. The echocardiogram’s findings were not relevant and there were no differences between groups. Since the majority of patients with SLE are double positive differences between two subspecificities of Ro (52 and 60) could not be analysed. On the other hand, no differences were found in cardiac conduction regarding the treatments received, the activity or damage indexes, or the analytical or clinical characteristics of the patients.

Conclusion:

The study results show that there are no differences in cardiac conduction according to the presence of anti-Ro antibodies in SLE patients. Thus, the cardiac screening in SLE patients with anti-Ro positive antibodies seems not helpful in clinical practice.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/usefulness-of-cardiac-screening-in-patients-with-systemic-lupus-erythematosus-and-anti-ro-positive-antibodies/