Title:Cardiovascular Disorders in Systemic Lupus Erythematosus
Volume: 24
Issue: 1
Author(s): Antonis A. Manolis, Theodora A. Manolis and Antonis S. Manolis*
Affiliation:
- Athens University School of Medicine, Athens, Greece
Keywords:
Systemic lupus erythematosus, autoimmune disease, cardiovascular disease, autoantibodies, antiphospholipid antibodies, coronary artery disease, heart block, neonatal lupus, myocardial infarction, myocarditis, sudden death, thromboembolism, echocardiography, multimodality cardiac imaging, coronary revascularization, valvular heart disease.
Abstract: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with multiorgan
and system involvement, including the Cardiovascular (CV) system. Cardiac involvement in these
patients is frequent and most often asymptomatic, at least in the early stages. It includes accelerated
atherosclerosis, premature Coronary Artery Disease (CAD), and a high risk of CV complications. The
risk of developing CV Disease (CVD) in SLE is linked not only with classical CV risk factors but
also with disease-specific factors, like the degree of activity, autoantibodies, organ damage, and type
of therapy. Clinical presentation comprises several clinical manifestations ranging from angina to
acute Myocardial Infarction (MI) and Sudden Cardiac Death (SCD). The leading cause of death in
SLE patients is from CVD due to accelerated atherosclerosis, which often has a more rapid progression
compared with the general population. The CV risk in SLE is greater when antiphospholipid
antibodies are present. Regarding diagnosis, apart from relevant blood tests, the simplest and readily
available diagnostic test, echocardiography, with its contemporary techniques that include global
longitudinal strain, is needed to provide a more thorough cardiac evaluation and allow for early management.
These aspects of the disease, together with issues regarding phenotypes, biomarkers, neonatal
lupus, heart block, SLE-related CV ailments such as coronary artery disease (CAD), myocarditis,
valvular heart disease, and the antiphospholipid syndrome, as well as diagnostic modalities, drug and
interventional therapies, and current relevant guidelines are all thoroughly reviewed and discussed in
this article.
