Left ventricular remodeling and dysfunction in systemic lupus erythematosus: A three-dimensional speckle tracking study

Abstract

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. (Echocardiography 2014;31:1085-1094)