Cardiovascular complications remain a major concern in patients with systemic lupus erythematosus (SLE), yet reliable tools for identifying individuals at higher risk are limited. A retrospective cohort study published in Lupus Science & Medicine evaluated whether transthoracic echocardiography (TTE) parameters were associated with major adverse cardiovascular and cerebrovascular events (MACCE) in patients with SLE.

Cardiac structural parameters were measured using TTE, and clinical and laboratory data were collected to assess disease activity. The left ventricular mass index (LVMI) was calculated for all participants. Propensity score matching was applied to reduce confounding bias. Independent predictors of MACCE were assessed using Cox proportional hazards regression models, and receiver operating characteristic (ROC) analysis determined the optimal LVMI cut-off for predicting adverse outcomes.

Compared with controls, the SLE cohort showed significantly higher aortic root diameter (p=0.002), right ventricular internal dimension in diastole (RVDd; p=0.038), interventricular septal thickness (IVST; p=0.033), left ventricular posterior wall thickness (LVPWT; p<0.001), left ventricular mass (LVM; p=0.025), LVMI (p=0.007), left ventricular posterior wall motion amplitude (LVPWMA; p=0.017), and interventricular septal motion amplitude (IVSMA; p=0.004). Multivariate analysis identified RVDd (p=0.027), LVMI (p=0.017), and low-density lipoprotein (LDL; p=0.036) as independent predictors of MACCE in SLE. ROC analysis showed an LVMI cut-off of 101.7 g/m² (AUC 0.751; 95% CI 0.653–0.849), with 76.9% sensitivity and 64.6% specificity.

These findings showed that higher LVMI was associated with the occurrence of MACCE in patients with SLE. TTE-derived structural parameters may contribute to cardiovascular risk stratification in SLE.