Echocardiographic features and predictors of pulmonary hypertension in patients with systemic lupus erythematosus
10.3760/cma.j.issn.1007-7480.2014.08.005
- VernacularTitle:系统性红斑狼疮心脏超声特点及肺高压危险因素分析
- Author:
Li LIU
;
Yongtai LIU
;
Yicong YE
;
Shuyang ZHANG
;
Lianfeng CHEN
;
Mengtao LI
;
Xiaofeng ZENG
- Publication Type:Journal Article
- Keywords:
Lupus erythematosus,systemic;
Echocardiography;
Hypertension,pulmonary;
Risk factors
- From:
Chinese Journal of Rheumatology
2014;18(8):525-530
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors of pulmonary hypertension in patients with systemic lupus erythematosus (SLE-PH).Methods Echo data of 598 SLE patients were collected,clinical characteristics of 107 suspected SLE-PH (PASP ≥40 mmHg,estimated by Echo) and 64 suspected moderate to severe PH (PASP ≥50 mmHg) were retrospectively analyzed.T-test,x2-test and Logisticregression were used for statistical analysis.Results Out of 598 patients 70.7%(423 patients) had abnormal Echo findings,and pericardial effusion in 45.5%(272 cases),valvular insufficiency in 31.3%(187 cases),suspected PH in 17.9%(107 cases),left ventricular enlargement in 5.9%(35 cases),left ventricular hypertrophy in 4.3%(26cases).In addition 1.7% had mitral valve prolapse,1.5% had mitral valve vegetation,and right ventricular enlargement in 6.5%(39 cases),LVEF<50% in 6.0%(36 cases),right ventricular systolic dysfunction in 2.2%(13 cases).Logistic regression analysis showed Raynaud's phenomenon (OR=3.205,95%CI:1.911-5.375,P=0.000),thrombocytopenia (OR=1.680,95%CI:1.049-2.689,P=0.031),hyperuricemia (OR=3.643,95%CI:2.154-6.164,P=0.000),and anti-U1RNP antibody positivity (OR=1.777,95%CI:1.099-2.874,P=0.019)were independent risk factors for suspected SLE-PH,fever (OR=0.576,P=0.029)and rash (OR=0.558,P=0.017) were independent protective factors for suspected SLE-PH.SLE duration (OR=1.145,95%CI:1.016-1.290,P=0.026) and Raynaud's phenomenon (OR=3.371,95%CI:1.126-10.086,P=0.030)were independent risk factors for suspected moderate to severe PH,nephritic syndrome (OR=0.042,P=0.009) was the in dependent protective factor for suspected moderate to severe PH.Conclusion Cardiac involvement is common in SLE patients.Screening for PH should be considered in SLE patients with thrombocytopenia,hyperuricemia,anti-U1RNP antibody positivity,particularly with Raynaud's phenomenon.