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Войти в исследования Rheumatology (Oxford, England) · 2025
Distinctive clinical traits of lupus-related myocarditis: a multicentre retrospective study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Ramirez Giuseppe A, Holopainen Noora E A, Gerosa Maria, De Luca Giacomo, Bellocchi Chiara, Arroyo-Sánchez Daniel, Sala Simone, Peretto Giovanni, Moroni Luca, Mastropaolo Francesca, Argolini Lorenza M, Pizzetti Giuseppe, Palmisano Anna, Esposito Antonio, Cariddi Adriana, Sartorelli Silvia, Campochiaro Corrado, Beretta Lorenzo, Bozzolo Enrica P, Caporali Roberto, Dagna Lorenzo
Аннотация
OBJECTIVES: Cardiovascular involvement in systemic lupus erythematosus (SLE) is frequent, but little is known about possible distinctive traits of SLE-related myocarditis (myoSLE) in comparison with patients with SLE (onlySLE) or myocarditis alone (onlyMyo).
METHODS: A retrospective analysis was performed comparing patients with myoSLE (n = 25) from three centres with consecutive patients with onlySLE (n = 279) and onlyMyo (n = 88). SLE patients were dichotomized by disease duration ≤1 vs >1 year into recent onlySLE/early myoSLE vs longstanding onlySLE/late myoSLE. Further stratification into disease duration of 1-5, 5-10 and >10 years was also performed. SLE disease activity index 2000 (SLEDAI-2K) was used to estimate disease activity. Myocarditis was diagnosed through biopsy or MRI.
RESULTS: Women were significantly more frequent among myoSLE than among onlyMyo (72% vs 43%; P = 0.013). Compared with onlyMyo, myoSLE patients had a higher frequency of conduction abnormalities (22% vs 5%; P = 0.046) and presented with numerically higher frequencies of left ventricular function compromise (48% vs 30%), along with higher pro-brain natriuretic peptide levels. Inflammation markers were higher in myoSLE compared with onlyMyo and with patients with onlySLE with >10 years of disease duration. SLEDAI-2K was significantly higher in late myoSLE than in longstanding onlySLE. Antiphospholipid syndrome was more frequent in myoSLE than in onlySLE. Multivariate analysis showed an association among myoSLE, anti-β-2-glycoprotein I antibodies (aB2GPI, P = 0.014) and a higher number of involved British Isles Lupus Assessment Group domains in patient history (P = 0.003).
CONCLUSION: myoSLE has unique clinical traits compared with other forms of myocarditis and is associated with aB2GPI and a more severe SLE course.
METHODS: A retrospective analysis was performed comparing patients with myoSLE (n = 25) from three centres with consecutive patients with onlySLE (n = 279) and onlyMyo (n = 88). SLE patients were dichotomized by disease duration ≤1 vs >1 year into recent onlySLE/early myoSLE vs longstanding onlySLE/late myoSLE. Further stratification into disease duration of 1-5, 5-10 and >10 years was also performed. SLE disease activity index 2000 (SLEDAI-2K) was used to estimate disease activity. Myocarditis was diagnosed through biopsy or MRI.
RESULTS: Women were significantly more frequent among myoSLE than among onlyMyo (72% vs 43%; P = 0.013). Compared with onlyMyo, myoSLE patients had a higher frequency of conduction abnormalities (22% vs 5%; P = 0.046) and presented with numerically higher frequencies of left ventricular function compromise (48% vs 30%), along with higher pro-brain natriuretic peptide levels. Inflammation markers were higher in myoSLE compared with onlyMyo and with patients with onlySLE with >10 years of disease duration. SLEDAI-2K was significantly higher in late myoSLE than in longstanding onlySLE. Antiphospholipid syndrome was more frequent in myoSLE than in onlySLE. Multivariate analysis showed an association among myoSLE, anti-β-2-glycoprotein I antibodies (aB2GPI, P = 0.014) and a higher number of involved British Isles Lupus Assessment Group domains in patient history (P = 0.003).
CONCLUSION: myoSLE has unique clinical traits compared with other forms of myocarditis and is associated with aB2GPI and a more severe SLE course.