Diastolic Dysfunction and Inflammatory Biomarkers in Lupus Nephritis

This cross-sectional observational study aims to investigate the correlation between echocardiographic parameters of left ventricular diastolic dysfunction (E/A ratio, e', E/e' ratio, LAVI, and LVEF) and systemic inflammatory biomarkers (CRP, ESR, NLR, PLR, and SII) in critically ill patients with lupus nephritis. A total of 90 participants will be enrolled and divided into three groups: control group without SLE or lupus nephritis (n=30), SLE without lupus nephritis (n=30), and SLE with lupus nephritis (n=30). Transthoracic echocardiography and blood sampling for inflammatory biomarkers will be performed at baseline (ICU admission). The findings may help evaluate the potential role of these biomarkers in early cardiac risk assessment in this patient population.

Inclusion Criteria: * Adult patients ≥ 18 years. Patients diagnosed with Systemic Lupus Erythematosus fulfilling the 2019 EULAR/ACR criteria, with biopsy-proven or clinically diagnosed lupus nephritis admitted to the intensive care unit (ICU), regardless of the primary cause of admission. Patients who provided informed consent to undergo echocardiographic assessment and blood sampling for inflammatory biomarkers. Exclusion Criteria: * Pediatric patients \< 18 years. Patients with pre-existing primary cardiac disease unrelated to SLE (e.g., congenital heart disease, valvular heart disease, ischemic heart disease, cardiomyopathy). Patients with poor echocardiographic acoustic window precluding adequate assessment of diastolic function. Patients with atrial fibrillation or other significant arrhythmias affecting Doppler-derived diastolic parameters. Patients with chronic kidney disease stage 5 on maintenance dialysis prior to the current critical illness. Patients with active sepsis-induced cardiomyopathy or septic shock, where hemodynamic instability may confound diastolic function assessment.