Prevalence, risk factors and echocardiographic predictors of pulmonary hypertension in systemic lupus erythematosus: towards a screening protocol

BackgroundSystemic lupus erythematosus (SLE) significantly affects the lungs and heart, and pulmonary hypertension (PH) is a severe manifestation that leads to considerable morbidity and mortality.ObjectivesWe aimed to determine the prevalence and risk factors of probable SLE-PH, assess the main ech...

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Published in:Rheumatic & musculoskeletal diseases open 2024-01, Vol.10 (1), p.e003674
Main Authors: Álvarez Troncoso, Jorge, Soto Abánades, Clara, Robles-Marhuenda, Ángel, Alcolea Batres, Sergio, Fernández Velilla Peña, María, Jiménez Valero, Santiago, Sorriguieta Torre, Raquel, Rios-Blanco, Juan José
Format: Article
Language:English
Subjects:
Biomarkers
Cardiac catheterization
cardiovascular diseases
Disease
Echocardiography
Female
Heart
Humans
hypertension
Hypertension, Pulmonary - diagnosis
Hypertension, Pulmonary - epidemiology
Hypertension, Pulmonary - etiology
Immunology
Lupus
lupus erythematosus, systemic
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - epidemiology
Male
Patients
Prevalence
Prospective Studies
Pulmonary arteries
Pulmonary hypertension
Regression analysis
Rheumatology
Risk factors
Serositis
Statistical analysis
Thrombosis
ultrasonography
Veins & arteries
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Summary:BackgroundSystemic lupus erythematosus (SLE) significantly affects the lungs and heart, and pulmonary hypertension (PH) is a severe manifestation that leads to considerable morbidity and mortality.ObjectivesWe aimed to determine the prevalence and risk factors of probable SLE-PH, assess the main echocardiographic predictors and develop a potential screening strategy.MethodsA prospective single-centre study was conducted on 201 patients with SLE who underwent transthoracic echocardiography. Patients meeting PH criteria were referred for right heart catheterisation (RHC).ResultsAmong patients, 88.56% were women, 85.57% were of Spanish origin and 43.78% had structural heart disease. Out of these, 16 (7.96%) had intermediate or high probability criteria for PH according to European Society of Cardiology (ESC) 2022. Six RHCs confirmed PH with a prevalence of 2.99% for SLE-PH and 1.99% for SLE-pulmonary arterial hypertension (PAH).Key risk factorsKey risk factors included age, cardiorespiratory symptoms, serositis, anti-Ro, cardiac biomarkers and altered pulmonary function tests (PFTs). PH was linked to a higher Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SDI) (mean SDI 4.75 vs 2.05, p
ISSN:2056-5933
2056-5933
DOI:10.1136/rmdopen-2023-003674