Objectives Cardiovascular involvement in systemic lupus erythematosus (SLE) is frequent but little is known about possible distinctive traits of SLE-related myocarditis (myoSLE) in comparison to patients with SLE (onlySLE) or myocarditis alone (onlyMyo). Methods A retrospective analysis was performed comparing patients with myoSLE (n = 25) from three centres with consecutive patients with onlySLE (n = 279) and onlyMyo (n = 88). SLE patients were dichotomised by disease duration ≤1 vs >1 year into recent onlySLE/early myoSLE vs longstanding onlySLE/late myoSLE. Further stratification into disease duration of 1–5, 5–10 and >10 years was also performed. SLE disease activity index 2000 (SLEDAI-2K) was used to estimate disease activity. Myocarditis was diagnosed through biopsy or magnetic resonance. Results Women were significantly more frequent among myoSLE than among onlyMyo (72% vs 43%; p= 0.013). Compared with onlyMyo, myoSLE patients had a higher frequency of conduction abnormalities (22% vs 5%; p= 0.046) and presented with numerically higher frequencies of left ventricular function compromise (48% vs 30%), along with higher pro-brain natriuretic peptide levels. Inflammation markers were higher in myoSLE compared with onlyMyo and to patients with onlySLE with >10 years of disease duration. SLEDAI-2K was significantly higher in late myoSLE than in longstanding onlySLE. Antiphospholipid syndrome was more frequent in myoSLE than in onlySLE. Multivariate analysis showed an association among myoSLE, anti-beta-2-glycoprotein I antibodies (aB2GPI, p= 0.014) and a higher number of involved British Isles Lupus Assessment Group domains in patient history (p= 0.003). Conclusion myoSLE has unique clinical traits compared with other forms of myocarditis and is associated with aB2GPI and a more severe SLE course.

中文翻译：

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狼疮相关心肌炎的独特临床特征：一项多中心回顾性研究


目的 系统性红斑狼疮 (SLE) 心血管受累很常见，但与 SLE (onlySLE) 或单纯心肌炎 (onlyMyo) 患者相比，SLE 相关心肌炎 (myoSLE) 可能存在的独特特征知之甚少。方法 对来自三个中心的 myoSLE 患者 (n = 25) 与连续患有 onlySLE (n = 279) 和 onlyMyo (n = 88) 的患者进行回顾性分析。 SLE 患者根据近期仅 SLE/早期 myoSLE 与长期仅 SLE/晚期 myoSLE 的病程 ≤1 与 >1 年进行分类。还进一步将病程分为 1-5 年、5-10 年和 >10 年。 SLE 疾病活动指数 2000 (SLEDAI-2K) 用于估计疾病活动。通过活检或磁共振诊断心肌炎。结果 女性在 myoSLE 中的发生率显着高于在 onlyMyo 中的发生率（72% vs 43%；p = 0.013）。与 onlyMyo 相比，myoSLE 患者的传导异常频率更高（22% vs 5%；p= 0.046），左心室功能损害的频率也更高（48% vs 30%），同时脑钠尿前体水平也较高肽水平。与 onlyMyo 以及病程为 >10 年的 onlySLE 患者相比，myoSLE 的炎症标志物更高。晚期 myoSLE 患者的 SLEDAI-2K 显着高于长期仅 SLE 患者。抗磷脂综合征在 myoSLE 中比在单纯 SLE 中更常见。多变量分析显示，myoSLE、抗 β-2-糖蛋白 I 抗体 (aB2GPI，p= 0.014) 和患者病史中涉及的不列颠群岛狼疮评估组域的数量较多 (p= 0.003) 之间存在关联。 结论 与其他形式的心肌炎相比，myoSLE 具有独特的临床特征，并且与 aB2GPI 和更严重的 SLE 病程相关。