Determining Factors of Echocardiographic Changes in Patients With Systemic Lupus Erythematosus: a Cross-sectional Analysis

Introduction: Systemic Lupus Erythematosus is a chronic autoimmune disease that affects multiple organs. Its pathogenesis involves a dysregulated immune response, but the complete mechanisms are not yet fully understood. Chronic inflammation associated with Lupus increases the risk of premature atherosclerosis, leading to cardiovascular events such as myocardial infarction and stroke, which reinforces the importance of preventive strategies to mitigate these risks. Objectives This study aimed to identify echocardiographic changes in patients with Systemic Lupus Erythematosus, considering the duration of the disease, the use of medications and comorbidities . Method The cross-sectional study was conducted from September 2023 to June 2024, with 22 volunteer patients from the Pará Rheumatic Patients Group (GARPA). Participants completed questionnaires on socioeconomic data and disease history, including time since diagnosis, comorbidities, and medication use. Subsequently, they underwent echocardiographic examinations performed by a single examiner. Statistical analysis was conducted using Fisher's exact test to associate clinical and socioeconomic variables with the observed cardiac changes, with significance set at p ≤ 0.05. Result Of the 22 patients studied, 90.9% were women, with a mean age of 40.82 ± 10.79 years. The majority (63.6%) were married, and 54.5% had completed high school. Regarding access to health care, 63.6% used the SUS. The most frequent comorbidities included systemic arterial hypertension (10.7%) and type 2 diabetes mellitus (7.1%), while 35.7% had no comorbidities. The mean time since diagnosis of the disease was 7.0 ± 4.34 years. In terms of medications, the most commonly used were hydroxychloroquine (25%) and prednisone (16.6%). Echocardiograms revealed pulmonary hypertension, mild mitral and aortic insufficiency, in addition to structural alterations such as left ventricular hypertrophy and interatrial septal aneurysm. Conclusion The duration of the disease and autoimmune, cardiovascular, musculoskeletal and neurological comorbidities are the main determinants of echocardiographic changes in patients with SLE. On the other hand, the main lines of treatment (antimalarials, corticosteroids and immunosuppressants) were not related to the outcomes.