Early onset left ventricular remodeling in juvenile systemic lupus erythematosus; Insight from 3-dimensional speckle tracking echocardiography. (November 2021)

• Record Type: Journal Article
• Authors: Agha, Hala M; Othman, Mahmoud A; El-Saiedi, Sonia; El Zahrae Hassan, Fatma; Taher, Heba; El-Sisi, Amal; Sobhy, Rodina; AbdelMassih, Antoine
• Is Part Of: Lupus. Volume 30:Number 13(2021)
• Page Start: 2114
• Page End: 2123
• Publication Date: 2021-11
• Subjects: Juvenile SLE -- 3-dimensional speckle tracking -- activity index -- left ventricular deformation; Systemic lupus erythematosus -- Periodicals; 616.772005
• DOI: 10.1177/09612033211051302
• Languages: English
• ISSNs: 0961-2033

Abstract

Background: Early diagnosis and treatment of myocardial affection in patients with systemic lupus erythematosus (SLE) are crucial. Objectives: To evaluate the ventricular systolic function in juvenile-onset systemic lupus erythematosus (j-SLE) patients by 3-D speckle tracking echocardiography (3D-STE) and to determine the predictors of left ventricular (LV) dysfunction if present. Methods: Twenty-six SLE patients without heart failure and 21 healthy controls were studied by standard echocardiogram and 3D-STE. Conventional parameters included LV ejection fraction (EF), fractional shortening (FS), and mitral annular plane systolic excursion (MAPSE). Global LV strain (GLS) and global area strain (GAS) were obtained by 3D-STE. Medical records, including diagnosis criteria, duration of disease, and SLE disease activity index (SLEDAI) were evaluated. Results: The mean age was similar in patients and controls 11.42 vs 11.48 years p = 0.93. The mean duration of the disease was 1.87 ± 1.02 years and SLEDAI ranged from 0 to 9. By conventional and tissue Doppler imaging echocardiography, only MAPSE was significantly lower in SLE patients compared to controls (14.56 vs 18.46 mm, p < 0.001). By 3D speckle tracking echocardiography, GLS and GAS were significantly reduced in SLE patients compared to controls (−15.07 vs −19.9.4%, −34.6% vs −39.7%, respectively, p < 0.001). Multiple linear regression and ROC analyses indicated that the SLEDAI score was the only predictive factor for the left ventricular remodeling. Conclusions: These results indicate that early subclinical LV dysfunction occur in jSLE patients even with normal EF and SLE disease activity might be a potential driver for LV deformation.