Do Serological Findings Correlate with Cardiovascular Manifestations of Systemic Lupus Erythematosus Patients in India?
Keywords:
Cardiovascular (CV) involvement, systemic lupus erythematosus, anti-ds DNA, and Antiphospholipids antibodies.Abstract
Introduction: Cardiovascular (CV) manifestations are common causes of morbidity and mortality in systemic lupus erythematosus (SLE). Autoantibodies anti-dsDNA and Antiphospholipids antibodies (APLA) are both pathogenic and diagnostic. Only few reports exists of correlation of serological positivity with CV manifestations in SLE, especially in Indian subjects. Aims and Methods: The study aimed to characterize the CV manifestations of SLE and correlate them with anti-dsDNA and APLA positivity. Anti-ds DNA was assayed by immunoflourescence staining on Hep-2 cells and APLA was measured by both liquid phase (lupus anticoagulant) and solid
phase (anti cardiolipin) ELISA. Results: All the study subjects (n=30) were females with a mean age of 23.07 years. The most frequent CV manifestation was that of pericardial involvement occuring in 63.3% (n=19) patients. Valvular heart disease [VHD (46.6%)], myocarditis (13.3%) and pulmonary artery hypertension [PAH(20%)] were the other major CV involvements. Serological assay
revealed 83.3% (n=25) positivity for anti-ds DNA, while APLA was positive in 36.7% (n=11) of the patients. APLA was significantly associated with VHD (p=0.0295), and also with increased pulmonary artery systolic pressure (p<0.001) and myocarditis (p=0.005). No significant association of anti-dsDNA was found with either VHD (p=0.102), myocarditis or PAH, but it was significantly associated with pericarditis (p=0.028). Conclusion: As observed in western series, APLA were significantly associated with VHD in SLE in our series; although in contrast, pericarditis was more prevalent in anti dsDNA positive than negative patients. These results could prompt early echocardiography in patients with SLE and APLA positivity, and invite larger studies to establish pathogenic role of these antibodies.
Caveat: This study was accepted for presentation at the Cardiological Society of India annual conference 2015 and abstracted in the Indian Heart Journal 67(2015):s125.
