PMID- 30273933 OWN - NLM STAT- MEDLINE DCOM- 20190306 LR - 20190306 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 13 IP - 10 DP - 2018 TI - The heart in systemic lupus erythematosus - A comprehensive approach by cardiovascular magnetic resonance tomography. PG - e0202105 LID - 10.1371/journal.pone.0202105 [doi] LID - e0202105 AB - BACKGROUND: In systemic lupus erythematosus (SLE), cardiac manifestations, e.g. coronary artery disease (CAD) and myocarditis are leading causes of morbidity and mortality. The prevalence of subclinical heart disease in SLE is unknown. We studied whether a comprehensive cardiovascular magnetic resonance (CMR) protocol may be useful for early diagnosis of heart disease in SLE patients without known CAD. METHODS: In this prospective, observational, cross-sectional study CMR including cine, late gadolinium enhancement (LGE) and stress perfusion sequences, ECG, and blood sampling were performed in 30 consecutive SLE patients without known CAD. All patients fulfilled at least 4/11 American College of Rheumatology (ACR) Criteria for the classification of SLE. RESULTS: 30 patients (83% female) were enrolled, mean age was 45+/-14 years and mean SLE disease duration was 10+/-8 years. 80% had low to moderate disease activity. All had a low SLE damage index. CMR was abnormal in 13/30 (43%), showing LGE in 9/13, stress perfusion deficits in 5/13 and pericardial effusion (PE) in 7/13. Patients with non-ischemic LGE had more often microalbuminuria while patients with stress perfusion deficits a history of hypertension, renal disorder as ACR criterion, repolarisation abnormalities on ECG and larger LV enddiastolic volume index. There was no correlation between clinical symptoms and CMR results. CONCLUSION: Our study shows that cardiac involvement as observed by CMR is frequent in SLE and not necessarily associated with typical symptoms. CMR may thus help to detect subclinical cardiac involvement, which could lead to earlier treatment. Additionally we identify possible risk factors associated with cardiac involvement. FAU - Burkard, Thilo AU - Burkard T AUID- ORCID: 0000-0001-6373-9820 AD - Department of Cardiology, University Hospital Basel, Basel, Switzerland. AD - Medical Outpatient Department, University Hospital Basel, Basel, Switzerland. AD - University of Basel, Basel, Switzerland. FAU - Trendelenburg, Marten AU - Trendelenburg M AD - University of Basel, Basel, Switzerland. AD - Division of Internal Medicine, University Hospital Basel, Basel, Switzerland. FAU - Daikeler, Thomas AU - Daikeler T AD - University of Basel, Basel, Switzerland. AD - Department of Rheumatology, University Hospital Basel, Basel, Switzerland. FAU - Hess, Christoph AU - Hess C AD - Medical Outpatient Department, University Hospital Basel, Basel, Switzerland. AD - University of Basel, Basel, Switzerland. FAU - Bremerich, Jens AU - Bremerich J AD - University of Basel, Basel, Switzerland. AD - Department of Radiology, University Hospital Basel, Basel, Switzerland. FAU - Haaf, Philip AU - Haaf P AD - Department of Cardiology, University Hospital Basel, Basel, Switzerland. AD - University of Basel, Basel, Switzerland. FAU - Buser, Peter AU - Buser P AD - Department of Cardiology, University Hospital Basel, Basel, Switzerland. AD - University of Basel, Basel, Switzerland. FAU - Zellweger, Michael J AU - Zellweger MJ AD - Department of Cardiology, University Hospital Basel, Basel, Switzerland. AD - University of Basel, Basel, Switzerland. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20181001 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - 0 (Contrast Media) SB - IM MH - Adult MH - Aged MH - Contrast Media/administration & dosage MH - Coronary Angiography MH - Coronary Artery Disease/*diagnostic imaging/etiology/physiopathology MH - Electrocardiography MH - Female MH - Heart/diagnostic imaging/*physiopathology MH - Humans MH - Lupus Erythematosus, Systemic/complications/*diagnostic imaging/physiopathology MH - Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Myocarditis/*diagnostic imaging/etiology/physiopathology MH - Myocardium/pathology MH - Tomography, X-Ray Computed PMC - PMC6167090 COIS- TB has received a research grant by the Research Funds of the University Hospital Basel, Basel, Switzerland, which was partially donated by Nycomed. There are no patents, products in development or marketed products to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials. EDAT- 2018/10/03 06:00 MHDA- 2019/03/07 06:00 PMCR- 2018/10/01 CRDT- 2018/10/02 06:00 PHST- 2018/04/06 00:00 [received] PHST- 2018/07/28 00:00 [accepted] PHST- 2018/10/02 06:00 [entrez] PHST- 2018/10/03 06:00 [pubmed] PHST- 2019/03/07 06:00 [medline] PHST- 2018/10/01 00:00 [pmc-release] AID - PONE-D-18-10360 [pii] AID - 10.1371/journal.pone.0202105 [doi] PST - epublish SO - PLoS One. 2018 Oct 1;13(10):e0202105. doi: 10.1371/journal.pone.0202105. eCollection 2018.