Changes in echocardiographic parameters in adolescents with long-term course of systemic lupus erythematosus

Background. Systemic lupus erythematosus is a chronic autoimmune disease that affects multiple organs and systems. Mortality among patients with SLE is higher compared to the general population, with cardiovascular diseases representing the leading cause of death. Early identification of subclinical cardiac dysfunction is therefore of particular importance in pediatric patients with systemic lupus erythematosus. Purpose – to assess the morphofunctional parameters of the left and right ventricular myocardium in adolescents with systemic lupus erythematosus, taking into account disease duration and activity. Materials and Methods. A total of 46 adolescents with systemic lupus erythematosus were examined. Findings were compared with those of age- and sex-matched healthy controls. At the time of examination, all patients had a disease duration of more than one year and were receiving baseline therapy. Echocardiographic assessment of the cardiac chambers was performed using M-mode and B-mode imaging. Results. Analysis of morphofunctional cardiac parameters revealed early signs of left ventricular diastolic dysfunction, demonstrated by a reduction in end-diastolic diameter (p < 0.05) and stroke volume (p < 0.01). These changes were accompanied by an increase in total peripheral vascular resistance (p < 0.001), resulting in decreased pressure gradients across the aortic (p < 0.001) and pulmonary (p < 0.01) valves. Regarding the right ventricle, significant increases in end-systolic diameter (p < 0.001), end-systolic volume (p < 0.001), end-diastolic volume (p < 0.001), stroke volume (p < 0.05), and cardiac output (p < 0.05) were observed, together with a pronounced reduction in ejection fraction (p < 0.001). Conclusions. Adolescents with systemic lupus erythematosus exhibit early signs of both systolic and diastolic myocardial dysfunction, with more pronounced abnormalities in the right ventricle. Progression of systolic dysfunction in both ventricles was associated with longer disease duration. Myocardial remodeling and functional capacity were not dependent on the degree of systemic lupus erythematosus activity.