Assessment of myocardial dysfunction of patients with systemic lupus erythematosus based on myocardial perfusion imaging and analysis of potential influencing factors.

Abstract

The incidence and prevalence of systemic lupus erythematosus (SLE) have increased annually over the past decade. The involvement of myocardium is one of the main reasons for the poor prognosis of patients with SLE. Identifying myocardial involvement in patients with autoimmune diseases and providing early targeted treatment can improve patient outcomes. The aim of this study is to evaluate myocardial dysfunction in patients with SLE using ^99mTc-MIBI rest gated myocardial perfusion imaging (rGMPI) and to investigate factors associated with myocardial dysfunction. 76 patients with SLE were prospectively enrolled in the study and 46 patients without autoimmune diseases or other inflammatory diseases who had undergone ^99mTc-MIBI rGMPI were selected as a control group. Results of relevant blood test indicators, echocardiography and rGMPI were recorded, and comparison was made between the two groups. Meanwhile, based on diagnostic results of rGMPI, SLE patients were divided into myocardial dysfunction group and normal myocardial function group and to analyze the influencing factors of myocardial dysfunction in SLE patients. The incidence of myocardial dysfunction was significantly higher in SLE patients than in controls (30.3% vs 0%, 2= 16.131, p < .001). Moderate/severe disease activity, decreased myocardial perfusion and positive anti-SSA/Ro52kDa antibody were associated with impaired myocardial function in SLE patients (OR = 2.753, 5.359, 3.646; p = .049, 0.015, 0.014). Positive anti-SSA/Ro52kDa antibody was is independently correlated with myocardial dysfunction in SLE patients [OR (95% CI) = 3.159 (1.071-9.316), p = .037]. In conclusion, ^99mTc-MIBI rGMPI can noninvasively evaluate myocardial dysfunction in patients with SLE and provide evidence for clinical treatment decisions. Positive anti-SSA/Ro52kDa antibody was an independent risk factor for myocardial dysfunction in SLE patients.