RT Journal Article
SR Electronic
T1 Lupus Myocarditis: Initial Presentation and Longterm Outcomes in a Multicentric Series of 29 Patients
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 24
OP 32
DO 10.3899/jrheum.160493
VO 44
IS 1
A1 Guillemette Thomas
A1 Fleur Cohen Aubart
A1 Laurent Chiche
A1 Julien Haroche
A1 Miguel Hié
A1 Baptiste Hervier
A1 Nathalie Costedoat-Chalumeau
A1 Karine Mazodier
A1 Mikael Ebbo
A1 Philippe Cluzel
A1 Nadège Cordel
A1 David Ribes
A1 Jean Chastre
A1 Nicolas Schleinitz
A1 Véronique Veit
A1 Jean-Charles Piette
A1 Jean-Robert Harlé
A1 Alain Combes
A1 Zahir Amoura
YR 2017
UL http://www.jrheum.org/content/44/1/24.abstract
AB Objective. Cardiac involvement during systemic lupus erythematosus (SLE) may include the pericardium, myocardium, valvular tissue, and coronary arteries. The aim of this study was to describe the clinical, biological, and radiological presentation of lupus myocarditis (LM) as well as the treatment response and longterm outcomes.Methods. We conducted a multicentric retrospective study of LM from January 2000 to May 2014.Results. Twenty-nine patients (3 men and 26 women) fulfilled the inclusion criteria (median age at the diagnosis of SLE: 30 yrs, range 16–57). Myocarditis was the first sign of SLE in 17/29 cases (58.6%). Troponin was elevated in 20/25 cases. Electrocardiogram results were abnormal in 25/28 cases. Echocardiography revealed low (≤ 45%) left ventricular ejection fraction (LVEF; 19/29, 66%) and pericardium effusion (20/29, 69%). Cardiac magnetic resonance imaging revealed delayed gadolinium enhancement in 9/13 patients (69%). Patients were treated with corticosteroids (n = 28), cyclophosphamide (CYC; n = 16), intravenous immunoglobulins (n = 8), and/or mycophenolate mofetil (n = 2). The median followup was 37 months. One month after the beginning of the treatment, 10/23 patients (43%) who had undergone echocardiography had an LVEF ≥ 55%. At the end of followup, 21/26 patients (81%) exhibited an LVEF ≥ 55%. Three patients died during followup, and 2 died from LM.Conclusion. LM is a severe manifestation of SLE. It can be the first manifestation of the disease or it can occur during followup, in particular in untreated patients. However, the longterm prognosis is typically positive. Patients with less severe disease exhibited good LVEF recovery without CYC.