Left Ventricular Remodeling and Dysfunction in Systemic Lupus Erythematosus: A Three-Dimensional Speckle Tracking Study

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 31; no. 9; pp. 1085 - 1094
• Main Authors: Huang, Bao-Tao, Yao, Hong-Mei, Huang, He
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.10.2014
• Subjects: Adolescent; Adult; cardiovascular disease; Echocardiography, Three-Dimensional - methods; Female; Humans; Lupus Erythematosus, Systemic - complications; Male; Middle Aged; Reproducibility of Results; Sensitivity and Specificity; systemic lupus erythematosus; ultrasound; Ventricular Dysfunction, Left - complications; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Remodeling - physiology; Young Adult; cardiovascular disease; systemic lupus erythematosus; ultrasound
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.12515

Objective To analyze left ventricular (LV) global structure and systolic function in patients with systemic lupus erythematosus (SLE) using the three‐dimensional (3D) speckle tracking imaging. Methods Thirty‐four SLE patients and 34 healthy subjects underwent 3D echocardiography to obtain LV ejection fraction (LVEF), sphericity index, 3D LV mass, 3D global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS). Disease activity was evaluated for all SLE patients by SLEDAI 2000 (SLEDAI‐2K) score. Results Age, gender, height, weight, diastolic blood pressure, and two‐dimensional (2D) LVEF were similar between the 2 groups. Despite no difference was found for sphericity index between the groups, 3D LV mass was increased in SLE patients. All components of strain were significantly reduced in SLE patients. Peak systolic GLS, GCS, GAS, and GRS in SLE patients and controls were −18.2 ± 2.9% versus −21.4 ± 2.5%, −18.4 ± 3.1% versus −20.6 ± 2.5%, −32.2 ± 4.4% versus −36.6 ± 3.4%, and 51.4 ± 10.2% versus 61.9 ± 10.0%, respectively (all P < 0.01). In multivariable regression analysis, SLE was independently associated with GAS (P < 0.001). In SLE patients, peak systolic GLS, GAS, GRS was significantly decreased in those with severe disease activity than among inactivity/mildly activity (all P < 0.05). GLS was independently correlated with SLEDAI score (P = 0.001). Conclusion Three‐dimensional speckle tracking imaging is a new simple, rapid method to indentify early abnormalities in SLE patients who may have normal LV systolic function with 2D echocardiography.