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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders: Autoinflammatory Disorders
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1504624

Coexistent Pleural Effusion is Associated with Aggravating Subclinical Myocardial Injury in Systemic Lupus Erythematous by Cardiovascular Magnetic Resonance Imaging

Provisionally accepted
Yang Zhi Yang Zhi Tian-yue Zhang Tian-yue Zhang Yong Zhu Yong Zhu Hao Zou Hao Zou Yi You Yi You Miao Wen Miao Wen Zhong Wang Zhong Wang Liang-chao Gao Liang-chao Gao Fu Bing Fu Bing Shu-Yue Pan Shu-Yue Pan *
  • Chengdu Fifth People's Hospital, Chengdu, China

The final, formatted version of the article will be published soon.

    Objective: Pleural effusion (PE) is a common pulmonary manifestation in patients with systemic lupus erythematosus (SLE), and is associated with disease activity. However, little is known regarding the additive effects of PE on cardiac function. Therefore, this study aimed to investigate multi-parameter cardiovascular magnetic resonance imaging (CMR) findings in SLE patients with PE and to explore whether cardiac involvement is associated with PE. Methods: Patients with SLE and age-matched/sex-matched healthy controls were included in this study. Patients with SLE were diagnosed according to the 2019 European League Against Rheumatism/American College of Rheumatology classification criteria. Moreover, the PE diagnosis was based on computed tomography, and the height of the effusion was > 5 mm. All enrolled individuals underwent CMR imaging, including cine and late gadolinium enhancement (LGE), T1, and T2 mapping imaging. The left and right ventricular function, LGE, T1, extracellular volume (ECV), and T2 values were evaluated. Results: A total of 111 patients with SLE were enrolled, of whom 26 (23.42%) had PE. White cell count, hemoglobin, CRP, ESR, and lactate dehydrogenase levels were higher in SLE patients with PE than in SLE patients without PE (P<0.05). LGE was more prevalent in SLE patients with PE compared with SLE patients those without PE (P<0.001). In addition, Native T1 (1348±65 ms vs. 1284±67 ms vs. 1261±41 ms; P<0.001), ECV (31.92±4.16% vs. 28.61±3.60% vs. 26.54±2.94%; P<0.001), and T2 (44.76±3.68 ms vs. 41.96±3.62 ms vs. 39.21±2.85 ms; P<0.001) values were higher in SLE patients with PE, intermediate in SLE patients without PE and lowest in control group. Linear regression analysis demonstrated that PE was independently associated with LGE (β=0.329; P<0.05), T1 (β=0.346; P<0.05), ECV (β=0.353; P<0.05), and T2 (β=0.201; P<0.05). Conclusions: SLE patients with PE have a higher prevalence of LGE and more diffuse myocardial fibrosis and edema than SLE patients without PE. Moreover, PE is associated with increased diffuse interstitial fibrosis and edema.

    Keywords: cardiovascular magnetic resonance imaging, late gadolinium enhancement, strains, Systemic Lupus Erythematous, T1 Mapping, T2 mapping

    Received: 01 Oct 2024; Accepted: 28 Oct 2024.

    Copyright: © 2024 Zhi, Zhang, Zhu, Zou, You, Wen, Wang, Gao, Bing and Pan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Shu-Yue Pan, Chengdu Fifth People's Hospital, Chengdu, China

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