Correlation of anti-cardiolipin antibodies with right ventricular systolic strain in systemic lupus erythematosus patients

Introduction

The association between anticardiolipin antibodies (aCL) and cardiac disease in the presence of systemic lupus erythematosus (SLE) has been reported in various clinical trials. However, the correlation between these auto-antibodies and right ventricular (RV) function has been inadequately investigated.

Objective

The present study investigated the possible correlation of the plasma anticardiolipin antibodies, as a marker of autoimmune phenomenon, with RV functions, assessed by right ventricular speckle tracking, in patients with systemic lupus erythematosus independent of significant pulmonary hypertension, systolic dysfunction or valvular disease.

Methods

Forty-six SLE patients and 20 healthy controls were enrolled in our study and submitted thorough history, complete clinical examination then clinical scoring according to SLEDAI-2K score and then laboratory investigations particularly plasma anticardiolipin Ig_G or Ig_M antibodies. Then echocardiography was done to assess cardiac dimensions, left ventricular systolic functions, right ventricular functions and lastly speckle tracking for assessment of the right ventricular systolic strain.

Results

Most of the study patients were young adult females with long-standing SLE (mean = 26 ± 3.1). All study patients had a high clinical SLE score (>6). All patients were normotensives and non-diabetics. No significant correlation was found between anticardiolipin titre and left ventricular dimensions or systolic functions. Significant negative correlation was found between RV strain and plasma level of both anticardiolipin Ig_M and Ig_G.

Conclusion

The present study identified that with the use of 2D speckle tracking in patients with SLE, right ventricular systolic function was significantly diminished with rising plasma titre of autoimmune (Ig_G or Ig_M) antibodies independent of cardiovascular risk factors.