BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune 
connective-tissue disease involving multiple organs and systems. Some evidence 
has demonstrated that disease activity could be associated with increased risk 
of organ damage.
OBJECTIVES: The aim of this study was to determine the association between 
systemic lupus erythematosus Disease Activity Index (SLEDAI) scores and 
subclinical cardiac involvement.
METHODS: This cross-sectional study was conducted on 45 SLE patients (88% 
female; mean age: 31.2 ± 8.2 years) from 2011 to 2013 in Mashhad, Iran. The 
patients had no clinical signs and symptoms of cardiac problems or risk factors 
for cardiovascular disease and were selected consecutively. All patients 
underwent complete echocardiographic examinations (using two dimensional (2D) 
tissue Doppler and 2D speckle tracking). Disease activity was evaluated by using 
the SLEDAI.
RESULTS: Patients with higher SLEDAI scores had higher pulmonary artery pressure 
rates (r = 0.34; P = 0.024; 95% CI (0.086 to 0.595)) and SLE durations (r = 
0.43; P = 0.004; 95% CI (0.165 to 0.664). The correlation between disease 
duration and left ventricular mass was also significant (r = 0.43; P = 0.009; 
95% CI (0.172 to 0.681)), even after adjusting for age (r = 0.405; P = 0.016). 
There was no correlation between SLEDAI scores or disease duration and the 
left/right ventricle systolic function parameters. This was true while assessing 
the right ventricle's diastolic function. A statistically significant 
correlation was found between mitral E/E' as an index of left ventricle 
diastolic impairment and the SLEDAI scores (r = 0.33; P = 0.037; 95% CI (0.074 
to 0.574)) along with disease duration (r = 0.45; P = 0.004; 95% CI (0.130 to 
0.662); adjusted for age: r = 0.478; P = 0.002).
CONCLUSIONS: Echocardiography is a useful noninvasive technique for screening 
subclinical heart problems in SLE patients. Although disease activity in general 
should suggest a closer follow-up, regular scanning would enable earlier 
detection of cardiovascular involvement and should not be confined to cases with 
higher SLEDAI indices or longer disease durations.