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Chronic tachycardia in lupus patients implied greater disease activity
Patients with systemic lupus erythematosus who experienced chronic tachycardia had greater disease activity and physical frailty, according to study results.
“Chronic tachycardia is associated with increased [systemic lupus erythematosus] disease activity, particularly in young people,” researcher Tammy Olsen Utset, MD, MPH,associate professor of medicine and director of the Lupus Clinical Program at the University of Chicago, told Healio.com.
Tammy Olsen Utset
Researchers used a university cross-sectional database to record disease activity, damage, disease manifestations, pain, anxiety and physical function of 243 patients with systemic lupus erythematosus (SLE). A heart rate of 95 beats per minute or more in at least three out of four sequential visits was used to define chronic tachycardia (CT). Demographic, disease-specific and self-reported symptoms between patients with and without CT were compared.
CT was present in 14.8% of SLE patients and associated with younger age at enrollment (P=.004); hospitalizations, adjusted for years of SLE (P=.001); current prednisone dose (P<.0001); serositis history (P=.03); anxiety score (P=.004); and poor physical function (P=.0017).
“All domains of the [Short Form-36] correlated strongly with CT, but on multivariate regression this correlation appeared to be driven by poor physical function,” the researchers reported.
SLE Disease Activity Index score (P=.03), younger age (P=.04) and poor physical function by the SF-36 PF domain (P=.006) independently correlated with CT under multivariate analysis, while anxiety trait and hemoglobin approached significance (both P=.08).
“The most surprising thing about the study is that tachycardia may be a disease activity indicator,” Utset said. “However, this was a cross-sectional study, so longitudinal data will be needed to determine if heart rate will fluctuate with disease activity.
“My most severe SLE patients tended to be tachycardic. I thought [tachycardia] would correlate with damage and secondary heart disease rather than activity itself, and I was surprised to find the correlation with current lupus activity and not with underlying heart disease.”
Disclosure: Utset is a consultant for Genentech, Human Genome Sciences/GlaxoSmithKline, and Anthera Pharmaceuticals, but received no consultative fees or grants related to this project.