Evaluation of endothelial and myocardial functions in patients with systemic lupus erythematosus

Ataman M. Evaluation of Endothelial and Myocardial Functions in Patients with Systemic Lupus Erythematosus. Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatrics, Pediatric Health and Diseases, Specialty Thesis, Eskişehir, 2025. Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease. Cardiovascular involvement represents one of the major causes of morbidity and mortality in SLE. This study aimed to evaluate subclinical cardiac and vascular alterations in patients diagnosed with SLE using echocardiographic and arterial stiffness parameters. Twenty SLE patients aged between 8 and 21 years, followed at the Pediatric Rheumatology Division of Eskişehir Osmangazi University Faculty of Medicine Hospital, and twenty age- and sex-matched healthy controls were included. Disease activity was assessed by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Cardiac morphology and functions were analyzed using conventional echocardiography, tissue Doppler imaging, and speckle tracking echocardiography (STE). Arterial stiffness was evaluated via pulse wave velocity (PWV) and augmentation index (AIx) measurements. No significant difference was found in global longitudinal strain (GLS) values between the SLE and control groups. However, segmental analysis revealed regional myocardial deformation impairment, particularly in patients with higher SLEDAI scores. A significant deterioration in right ventricular systolic and diastolic functions was detected in the SLE group. PWV and AIx values showed no significant differences between groups. In conclusion, even when conventional echocardiographic findings appear normal, subclinical cardiac dysfunction can be detected in pediatric SLE patients through speckle tracking echocardiography and tissue Doppler techniques. Early detection of cardiac involvement is clinically important for preventing long-term complications. The limited number of studies in the pediatric population enhances the significance of these findings. Key Words: Pediatric SLE, strain analysis, arterial stiffness