A new study suggests preload deficiency could be the underlying cause of fatigue and exercise intolerance in people with systemic lupus erythematosus (SLE). Preload deficiency is a condition where the heart’s capacity to fill with blood before pumping (preload) is reduced, leading to symptoms like fatigue and exercise intolerance. Exercise is particularly helpful for people with lupus, and most people with lupus can take part in some form of activity.
A group of 10 women with SLE with debilitating exercise intolerance was studied. The women did not have anemia, active SLE, or other conditions that would cause debilitation. Various cardiac and blood tests were conducted on the women. All study participants showed reduced exercise tolerance, and in five participants, right heart catheterisation during exercise confirmed preload deficiency. To address this, participants were advised to increase fluid intake (to 128 oz/day), increase sodium intake (to more than 5 g/day), and use compression stockings. Ivabradine was added to the regimen when fluids and sodium were not sufficient or tolerated. All participants reported improvement in symptoms. Additionally, the study participants also had low or undetectable NT-proBNP concentrations (a protein released by the heart under stress) which the researchers believe could be a potential biomarker for preload deficiency.
These findings highlight a potentially treatable cause of fatigue and exercise intolerance in some people with SLE. Future research is needed to determine preload deficiency’s prevalence and understand its role in SLE. Learn more about staying active when you have lupus.
Read the study