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2015 ; 128
(19
): 2588-94
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Lupus Myocarditis: A Case-Control Study from China
#MMPMID26415795
Zhang L
; Zhu YL
; Li MT
; Gao N
; You X
; Wu QJ
; Su JM
; Shen M
; Zhao LD
; Liu JJ
; Zhang FC
; Zhao Y
; Zeng XF
Chin Med J (Engl)
2015[Oct]; 128
(19
): 2588-94
PMID26415795
show ga
BACKGROUND: Myocarditis is an uncommon but serious manifestation of systemic
lupus erythematosus (SLE). This study aimed to investigate clinical
characteristics and outcomes of lupus myocarditis (LM) and to determine risk
factors of LM in hospitalized Chinese patients with SLE. METHODS: We conducted a
retrospective case-control study. A total of 25 patients with LM from 2001 to
2012 were enrolled as the study group, and 100 patients with SLE but without LM
were randomly pooled as the control group. Univariable analysis was performed
using Chi-square tests for categorical variables, and the Student's t-test or
Mann-Whitney U-test was performed for continuous variables according to the
normality. RESULTS: LM presented as the initial manifestation of SLE in 7
patients (28%) and occurred mostly at earlier stages compared to the controls
(20.88 ± 35.73 vs. 44.08 ± 61.56 months, P = 0.008). Twenty-one patients (84%)
experienced episodes of symptomatic heart failure. Echocardiography showed that
23 patients (92%) had decreased left ventricular ejection fraction (<50%) and all
patients had wall motion abnormalities. A high SLE Disease Activity Index was the
independent risk factor in the development of LM (odds ratio = 1.322, P < 0.001).
With aggressive immunosuppressive therapies, most patients achieved satisfactory
outcome. The in-hospital mortality was not significantly higher in the LM group
than in the controls (4% vs. 2%,P = 0.491). CONCLUSIONS: LM could result in
cardiac dysfunction and even sudden death. High SLE disease activity might
potentially predict the occurrence of LM at the early stage of SLE.
Characteristic echocardiographic findings could confirm the diagnosis of LM.
Early aggressive immunosuppressive therapy could improve the cardiac outcome of
LM.
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