July - September 2015, Volume 11, Issue 3

Gusetu G, Pop D, Zdrenghea D, Matuz R, Petcu A, Rinzis M, Cismaru G, Rednic S

The Correlation between Exercise NT-pro-BNP and Asymptomatic Cardiac Dysfunction in Patients with Systemic Lupus Erythematosus

Acta Endo (Buc) 2015, 11 (3): 319-324
doi: 10.4183/aeb.2015.319

Background. Myocardial involvement is frequent in patients with systemic lupus erythematosus (SLE), and its early detection assures the prognosis improvement. Objective. To assess the NT-proBNP levels and its correlation with systolic longitudinal performance, during exercise testing in a SLE population Subjects and Methods. The study included 30 SLE patients (80 % females), with a mean age of 44.8 ± 9.91 years. All subjects were submitted to an echo Doppler examination, including the determination of the global longitudinal strain (GLS). Also, they performed a cardiopulmonary exercise testing (CPE) on cycloergometer, assessing the peak oxygen uptake. Venous blood samples were taken and NT-proBNP levels were determined before exercise, at peak effort and two hours after exercise. Results. The left ventricular ejection fraction was normal but GLS was low in SLE patients ( -16.96 ± 3.12%, vs. -19.5 ± 3.05% normal range) and much lower in those with diastolic dysfunction (-14.5 ± 2.3% vs. - 19.2± 1.85%, p=0.0014). During CPE, the patients performed a mean 71.96% ± 13.9% of predicted VO2 max. The mean values of NT-proBNP were: 186.84 ± 186.8 pg/mL at rest, 221.68 ± 245.76 pg/mL at peak effort and 412.48 ± 400.28 pg/mL post effort. No correlation was registered between GLS and peak VO2. We found a negative correlation between GLS ant NT-proBNP at peak effort (r = -0.508) and post exercise (r=-0.623). Conclusion. The exercise NT-proBNP levels can be used together with GLS for an early detection of systolic dysfunction in SLE patients.

Keywords: systemic lupus erythematosus, NT-proBNP, cardiopulmonary exercise testing, global longitudinal strain.

Correspondence: Dana Pop MD, Rehabilitation Hospital, Cardiology, Viilor Street, No 46-50, Cluj-Napoca, 428063, Romania, E-mail: pop7dana@yahoo.com