Lupus et cœur : expérience d’un CHU.

Systemic lupus erythematosus is a systemic disease in which various organs are affected. Cardiac involvement in lupus is a frequent and serious manifestation. Our aim in this study was to characterise lupus patients with cardiac involvement from a demographic, clinical, biological and prognostic point of view, and to identify factors predisposing to this type of involvement. Materials and methods: We analysed a single-centre retrospective cohort of 269 patients with systemic lupus from January 2012 to December 2020. The patients included met the criteria of the American College of Rheumatology (ACR) [18], or the classification criteria of the Systemic Lupus International Collaborating Clinics (SLICC) [19]. Induced lupus and pure cutaneous lupus were excluded from the study. Cardiac manifestations were analysed. Results: Of the 269 patients followed for systemic lupus, 83 had cardiac involvement (32 %). 72 women and 11 men, sex ratio F/M 6.54. The mean age at diagnosis was 35 ± 12.4 years [16-70]. The various cardiac manifestations during lupus are: pericarditis in 22 % of cases (n = 61), myocarditis in 5.2 % of cases (n = 14), endocarditis in 0.7 % of cases (n = 2), pulmonary arterial hypertension (PAH) in 2.6 % of cases (n = 7), while coronary artery disease specific to lupus was observed in 1.1 % of cases (n = 3). The risk factors for cardiac involvement according to our study were: male sex (OR = 3.75, CI95 % 1.4-10.07), the presence of pulmonary involvement, especially pleurisy (OR = 4.77, CI95 % 2.48-9.16), the presence of psychiatric disorders (OR 3.37, CI95 % 1.23-9.19) and high disease activity with a SLEDAI greater than 12 (OR 3.8, CI 95 % 1.98-7.31). When analysing the involvement of the different cardiac manifestations in the death of lupus patients, myocarditis could have an impact on the prognosis of the disease (p = 0.08), but the other manifestations (pericarditis, endocarditis, coronary artery disease and PAH) were not associated with death. Conclusion: The risk factors for cardiac involvement in our series are: male sex, the presence of pulmonary involvement, especially pleurisy, the presence of psychiatric disorders and high disease activity with a SLEDAI of more than 12. Given its frequency and severity, this condition should be systematically investigated. [ABSTRACT FROM AUTHOR]