• Guillemette Thomas, Fleur Cohen Aubart, Laurent Chiche, Julien Haroche, Miguel Hié, Baptiste Hervier, Nathalie Costedoat-Chalumeau, Karine Mazodier, Mikael Ebbo, Philippe Cluzel, Nadège Cordel, David Ribes, Jean Chastre, Nicolas Schleinitz, Véronique Veit, Jean-Charles Piette, Jean-Robert Harlé, Alain Combes, and Zahir Amoura.
• From the APHP, Service de Médecine Interne, Institut E3M, Hôpital de la Pitié-Salpêtrière and Sorbonnes Universités, UPMC Université Paris VI, Paris; Service de Réanimation, and Service de Médecine Interne, Hôpital Européen, Marseille; Centre National de Référence pour les Maladies systémiques rares, Lupus et Syndrome des Anticorps antiphospholipides, Hôpital de la Pitié-Salpêtrière, Paris; APHP, Service de Médecine Interne, Centre de référence maladies auto-immunes et systémiques rares, Paris; Université Paris Descartes-Sorbonne Paris Cité, Paris; Assistance Publique-Hôpitaux de Marseille (APHM), Service de Médecine interne, Hôpital de la Conception, Marseille; APHM, Service de Médecine interne, Hôpital de la Timone, Marseille; APHP, Service de Radiologie, Pitié-Salpêtrière, Paris; Unité de Dermatologie-Médecine Interne, EA4546, CHU Pointe à Pitre, Guadeloupe; Département de Néphrologie et Transplantation, CHU de Toulouse, Toulouse; APHP, Service de Réanimation, INSERM, UMRS-1166, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
• J Rheumatol. 2017 Jan 1; 44 (1): 24-32.

ObjectiveCardiac involvement during systemic lupus erythematosus (SLE) may include the pericardium, myocardium, valvular tissue, and coronary arteries. The aim of this study was to describe the clinical, biological, and radiological presentation of lupus myocarditis (LM) as well as the treatment response and longterm outcomes.MethodsWe conducted a multicentric retrospective study of LM from January 2000 to May 2014.ResultsTwenty-nine patients (3 men and 26 women) fulfilled the inclusion criteria (median age at the diagnosis of SLE: 30 yrs, range 16-57). Myocarditis was the first sign of SLE in 17/29 cases (58.6%). Troponin was elevated in 20/25 cases. Electrocardiogram results were abnormal in 25/28 cases. Echocardiography revealed low (≤ 45%) left ventricular ejection fraction (LVEF; 19/29, 66%) and pericardium effusion (20/29, 69%). Cardiac magnetic resonance imaging revealed delayed gadolinium enhancement in 9/13 patients (69%). Patients were treated with corticosteroids (n = 28), cyclophosphamide (CYC; n = 16), intravenous immunoglobulins (n = 8), and/or mycophenolate mofetil (n = 2). The median followup was 37 months. One month after the beginning of the treatment, 10/23 patients (43%) who had undergone echocardiography had an LVEF ≥ 55%. At the end of followup, 21/26 patients (81%) exhibited an LVEF ≥ 55%. Three patients died during followup, and 2 died from LM.ConclusionLM is a severe manifestation of SLE. It can be the first manifestation of the disease or it can occur during followup, in particular in untreated patients. However, the longterm prognosis is typically positive. Patients with less severe disease exhibited good LVEF recovery without CYC.

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