TỔN THƯƠNG VAN TIM Ở NGƯỜI BỆNH VIÊM THẬN LUPUS TẠI BỆNH VIỆN BẠCH MAI NĂM 2024 – 2025

Abstract

Objectives: This study aimed to describe valvular heart involvement using color Doppler echocardiography and to examine its association with clinical and paraclinical characteristics in patients with lupus nephritis. Subjects and Methods: A cross-sectional descriptive study was conducted on 200 patients diagnosed with lupus nephritis and treated at Bach Mai Hospital from August 2024 to June 2025. Clinical and echocardiographic data were collected and analyzed to determine the prevalence and patterns of valvular involvement, as well as related risk factors. Results: The mean age was 37.61 ± 17.08 years, with a female-to-male ratio of 85% to 15%. Valvular lesions were observed in 83.5% of patients. The most commonly affected valve was the mitral valve (77.5%), followed by the aortic valve (32.5%), tricuspid valve (17%), and pulmonary valve (1.5%). The mean ejection fraction (EF) was 61.92 ± 7.71%. Pulmonary hypertension was present in 42.5% of cases. Pericardial effusion was found in 40.5% of patients. There were no significant differences in age, gender, SLE Disease Activity Index (SLEDAI), or presence of nephrotic syndrome between patients with and without valvular lesions. Patients with a glomerular filtration rate (GFR) < 60 ml/min/1.73 m² had a 3.3-fold increased risk of valvular heart disease compared to those with GFR ≥ 60 ml/min/1.73 m² (OR = 3.30; 95% CI: 1.50–7.26; p = 0.003). Anemia was associated with a 4.45-fold increased risk of valvular lesions (OR = 4.451; 95% CI: 1.893–10.467; p = 0.001). Conclusion: In lupus nephritis, age, gender, disease activity (SLEDAI), and presence of nephrotic syndrome were not significantly associated with valvular heart lesions. However, decreased renal function and anemia were significantly associated with an increased risk of valvular involvement.