185 ASYMPTOMATIC CARDIOMYOPATHY IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

Abstract

Twelve adolescents with SLE were studied by M-mode echocardiography. All patients had received prednisone for the duration of their illness (1 mo-7 yrs). None had symptomatic heart disease although the following were present: cardiomegaly by x-ray (4 pts), hypertension (8 pts), nonspecific ECG changes (5 pts). Pericardial effusion was present in 6 patients. Left ventricular (LV) end diastolic dimension, percent minor axis shortening and the ratio of pre-ejection period to ejection time were normal. Posterior wall thickness (p < .001), calculated LV mass (p < .05) and LV mass/volume (p < .025) were abnormal but not related (linear regression) to blood pressure. Maximum rates of continuous LV dimension change (dD/dt) were normal. However, the time from electrocardiographic Q-wave to minimum and maximum dD/dt (p < .025) and Q-wave to mitral valve opening (p < .05), corrected for heart rate, were abnormal. These data suggest that clinically unsuspected cardiomyopathy is associated with SLE and that it is not defined by the usually measured M-mode echocardiographic parameters.

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