Evaluation of subclinical myocardial involvement in systemic lupus erythematosus using multiparametric cardiac magnetic resonance imaging

Abstract

Purpose: This study aimed to characterize subclinical myocardial involvement and assess the alterations in biventricular cardiac function in patients with systemic lupus erythematosus (SLE) using cardiac magnetic resonance (CMR) imaging. Method: This study included 42 patients with SLE, categorized into two subgroups: those with subclinical myocardial involvement and a control group with no myocardial involvement. Additionally, 20 age- and sex-matched healthy controls (HCs) underwent CMR examinations. Cardiac parameters were compared among the three groups, and potential relationships between imaging findings and clinical measures were analyzed. Results: Individuals with subclinical myocardial involvement demonstrated increased LVEDVI, RVEDVI, native T1 values, ECV, and T2 values compared to the SLE control group and/or HCs. Conversely, reduced RVEF, LV-GCS, LV-GLS), LV- (D-LPSR/D-CPSR), RV-GLS, and D-LPSR were observed in this subgroup. C3 levels were negatively correlated with several CMR parameters(LV-GCS, LV-GLS, native T1,ECV, T2). PLT was negatively correlated with LV-GCS, while ESR showed a positive correlation with ECV. Conclusion: Abnormal changes detected by the FT technique (e.g., myocardial strain, strain rate abnormalities) may precede the onset of a decline in EF, enabling detection of myocardial injury before ejection fraction decreases. LV GCS may serve as valuable indicators for identifying subclinical myocardial involvement in SLE, particularly in patients with contrast allergies or severe renal impairment.