Understanding subclinical heart disease and cytokine profile in cardiorheumatic care of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) affects several organs and systems. The involvement of the cardiovascular system confers high morbidity and mortality in patients, so the detection of possible subclinical or advanced cardiac involvement at the time of diagnosis will lead to preventive solutions according to the degree and type of cardiovascular involvement. New echocardiographic techniques such as left ventricular global longitudinal strain (LV-GLS) allow the detection systolic dysfunction of the LV before the onset of symptoms secondary to heart failure. The objective of the study was to compare the GLS strain of the LV of asymptomatic patients with diagnosed SLE with a healthy control (HC) group. This prospective cross-sectional comparative study included asymptomatic patients with systemic lupus erythematosus (SLE) and no history or clinical evidence of heart failure. All participants underwent transthoracic echocardiography, and left ventricular systolic function was assessed using three-dimensional left ventricular ejection fraction (3D-LVEF) and global longitudinal strain (GLS). Inflammatory status was evaluated by measuring circulating levels of IL-4, IL-2, CXCL10, CXCL8, IL-1β, TNF-α, CCL2, IL-17A, IL-6, IL-10, IFN-γ, IL-12(p70), and active free TGF-β1. Echocardiographic and inflammatory parameters were compared with those of a self-reported healthy control group." A total of 40 participants were included, all of whom were women. Compared with self-reported healthy controls, patients with SLE exhibited lower left ventricular global longitudinal strain (LV-GLS; p = 0.018), left ventricular ejection fraction (LVEF; p = 0.027), and left atrial strain during both the reservoir (p = 0.0157) and conduit phases (p = 0.0075). In contrast, patients with SLE had greater interventricular septal thickness (p = 0.0001), posterior wall thickness (p = 0.0055), relative wall thickness (p = 0.03), left ventricular mass index (p = 0.0034), and a higher prevalence of concentric remodeling (p < 0.0001). Among patients with active SLE, IL-12(p70) levels were positively correlated with interventricular septal thickness (r = 0.76, p = 0.0112). Compared to healthy controls, asymptomatic patients with SLE and no history of heart failure had lower LV-GLS and LVEF values, despite preserving left ventricular systolic function. Higher IL-12 (p70) levels were associated with greater interventricular septum thickness in patients with active SLE.