SLE patients at increased risk for pulmonary hypertension

Patients with systemic lupus erythematosus were at increased risk for a rare complication of pulmonary hypertension, according to recent study results.

Researchers in Turkey retrospectively studied 122 patients with systemic lupus erythematosus (SLE; mean age, 38.5 years; 88% women) who were admitted to a rheumatology outpatient clinic during a 6-month period. Patients were considered to have pulmonary hypertension (PH) if they had a systolic pulmonary arterial pressure of 40 mm Hg or greater by Doppler echocardiography.

Sixty-five patients (53.3%) had at least one echocardiography; 10 (8.2%) were diagnosed with PH. The number of PH patients was reduced to nine (7.4%) when one patient was excluded because of normal pulmonary artery pressure at right heart catheterization. Causes of PH included thromboembolic events (four patients, two were chronic), left-sided heart disease (two patients), pulmonary arterial hypertension (one patient), high cardiac output state (one patient) and transient elevation of systolic pulmonary artery pressure (one patient with a history of venous thromboembolism). Rates for venous thromboembolic disease were greater in patients with SLE and PH than in those with SLE but not PH; 50% vs. 6.3%, respectively (P=.001).

With medical treatment during follow-up, all PH patients displayed clinical improvement.

“Pulmonary hypertension is a rare complication of SLE,” the researchers concluded. “This study highlights the complexity of the differential diagnosis of PH in patients with SLE once again and emphasizes the importance of pulmonary thromboembolism as a cause of PH.

“Screening symptomatic patients regularly by echocardiography may be useful not only for the early diagnosis of PH but also for defining other cardiovascular disease risk in SLE. To develop proper strategies for diagnosis and treatment of PH in SLE, prospective studies are needed.”

Disclosure: The researchers report no relevant financial disclosures.