Subclinical left ventricular dysfunction during systemic lupus erythematosus activity with follow-up after remission – A speckle tracking echocardiographic study

Taha, Moataz; Labib, Dina; Baghdady, Yasser; El-Ghobashy, Nehal; Elamragy, Ahmed

doi:10.1016/j.ejr.2022.03.003

Cited by 4 publications

(3 citation statements)

References 28 publications

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“…Impairment in longitudinal strain has been suggested as an index for evaluating ventricular function. Recent studies using speckle tracking echocardiography (STE) have reported that SLE patients show impairment in cardiac strain reflecting cardiac dysfunction [34][35][36]. Nikdoust et al reported that SLE patients with no reported cardiac symptoms had significant decreases in longitudinal strain [34], whilst Taha et al showed that SLE patients with active disease had impairment in longitudinal, circumferential and radial strain on STE [35].…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies using speckle tracking echocardiography (STE) have reported that SLE patients show impairment in cardiac strain reflecting cardiac dysfunction [34][35][36]. Nikdoust et al reported that SLE patients with no reported cardiac symptoms had significant decreases in longitudinal strain [34], whilst Taha et al showed that SLE patients with active disease had impairment in longitudinal, circumferential and radial strain on STE [35]. Meanwhile Zhong et al demonstrated that disease activity and markers of inflammation (specifically CRP, ESR and C3/C4) correlated with decreased speckle strain parameters, indicating subclinical myocardial injury [36].…”

Section: Discussionmentioning

confidence: 99%

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Reduced left ventricular function on cardiac MRI of SLE patients correlates with measures of disease activity and inflammation

Hagiwara,

Montano,

Tumurkhuu

et al. 2023

Preprint

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Background: Women with SLE have an elevated risk of cardiovascular disease. Many women with SLE frequently report chest pain in the absence of obstructive coronary artery disease (CAD) due to coronary microvascular dysfunction (CMD), a form of ischemia with no obstructive CAD. Echocardiographic studies have shown that SLE patients have reduced left ventricular (LV) function, which may also correlate with higher SLE disease activity scores. As such, we used cardiac magnetic resonance imaging (cMRI) to investigate the relationship between SLE, related inflammatory biomarkers, and cardiac function in female SLE patients. Methods: We performed stress cMRI in women with SLE and chest pain with no obstructive CAD (n=13, all met ACR 1997 criteria,) and reference controls (n=22) using our published protocol. We evaluated LV function, tissue characterization (T1 mapping, ECV), and delayed enhancement, using CV142 software (Circle Cardiovascular Imaging Inc, Calgary, AB, Canada). Myocardial perfusion reserve index (MPRI) was calculated using our published protocol. SLEDAI and SLICC Damage Index (DI) were calculated per validated criteria. Serum samples were analyzed for inflammatory markers and autoantibodies. Wilcoxon rank-sum test was performed on clinical values with CMD and no CMD SLE subjects, and on cMRI values with all SLE subjects and controls. Correlation analysis was done on clinical values, and cMRI values on all SLE subjects. Results: Overall, 40% of SLE subjects had MPRI values < 1.84, consistent with CMD. Compared to controls, SLE subjects had significantly lower LVEF, and higher LVESVi and LVMi. Corresponding to this, radial, longitudinal, and circumferential strain were significantly lower in the SLE subjects. In correlation analysis of serum inflammatory biomarkers to cMRI values in the SLE subjects, SLICC DI was related to worse cardiac function (lower radial, circumferential and longitudinal strain) and higher T1 time. Additionally, fasting insulin and ESR were negatively correlated with LVMi. Fasting insulin also negatively correlated with ECV. CRP had a positive association with LVESV index and CI and a negative association with longitudinal strain. Conclusions: Among women with SLE with chest pain and no obstructive CAD, 40% have CMD. While evaluations of known inflammatory markers (such as CRP and ESR) predictably correlated with decreased cardiac function, our study found that decreased fasting insulin levels as a novel marker of diminished LV function. In addition, low insulin levels were observed to correlate with increased LVMi and ECV, suggesting a cardioprotective effect of insulin in SLE patients. We also noted that SLICC DI, an assessment of SLE damage, correlates with cardiac dysfunction in SLE. Our findings underline the potential of non-invasive cMRI as a tool for monitoring cardiovascular function in SLE, particularly in patients with high SLICC DI, ESR and CRP and low fasting insulin levels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reduced left ventricular function on cardiac MRI of SLE patients correlates with measures of disease activity and inflammation

Hagiwara,

Montano,

Tumurkhuu

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…This is unlike tissue Doppler imaging (TDI), which can assess the regional systolic function of LV by measuring strain, strain rate, tissue velocities, and displacement. One of the emerging techniques that caught attention in recent years was the two-dimensional speckle tracking echocardiography (2D STE), which can evaluate the regional systolic function and can detect early changes in myocardial function [ 9 , 10 ]. Therefore, we hypothesized that 2D STE can detect the subtle impairment of LV systolic function in uremic patients with normal LVEF.…”

Section: Introductionmentioning

confidence: 99%

Comparing Left Ventricular Structure and Functions in End-Stage Renal Disease Using Conventional Echocardiography and 2D Speckle Tracking Echocardiography

Habib,

Hasan,

Abd Elaziz

et al. 2024

Cureus

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Background: Patients on hemodialysis (HD) are prone to various cardiovascular complications. Two-dimensional speckle tracking echocardiography (2D STE) is an innovative technique for early myocardial dysfunction detection, even with normal ejection fraction (EF). Objective: We aim to detect left ventricle (LV) dysfunction in regular hemodialysis patients using 2D STE compared to traditional echocardiography. Methods: The study comprised 30 patients with end-stage renal disease (ESRD), subdivided according to left ventricular mass index (LVMI) into group 1 with left ventricular hypertrophy (LVH) (n=19) and group 2 without LVH (n=11). Another 30 healthy control subjects were recruited as group 3. The EF, average systolic velocity (Sa), and 2D LV strain were taken as measures of LV systolic function. The indicators for diastolic function included the E/A ratio and E velocity/peak early diastolic velocity. Results: Regarding the parameters of LV systolic and diastolic functions assessed by traditional echocardiography, we found no significant difference between groups 1 and 2. However, using 2D STE, we observed significant differences in the average Sa velocity (p=0.025), average LV strain (p=0.03), 2D global longitudinal strain (GLS) (p=0.03), E/Ea (p=0.003), and LV myocardial performance index (MPI) (p=0.006). Also, a significant positive correlation was found between LVMI and left ventricular end-diastolic diameter (LVEDD) (p<0.01, r=0.63), EF measured by 2D (p=0.034, r=0.39), mitral E/A ratio (p=0.03, r=0.49), and mitral E/Ea (p<0.01, r=0.72). There was a significantly strong negative correlation between LVMI and 2D average LV strain (p=0.034, r=-0.39). Conclusion: We concluded that 2D STE is more sensitive than a conventional echo in detecting early LV systolic and diastolic dysfunction even in patients with normal EF.

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Serum beta2-microglobulin level in systemic lupus erythematosus patients: Relation to disease activity

Allam

Ali

El-Abed

et al. 2023

The Egyptian Rheumatologist

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Subclinical left ventricular dysfunction during systemic lupus erythematosus activity with follow-up after remission – A speckle tracking echocardiographic study

Cited by 4 publications

References 28 publications

Reduced left ventricular function on cardiac MRI of SLE patients correlates with measures of disease activity and inflammation

Reduced left ventricular function on cardiac MRI of SLE patients correlates with measures of disease activity and inflammation

Comparing Left Ventricular Structure and Functions in End-Stage Renal Disease Using Conventional Echocardiography and 2D Speckle Tracking Echocardiography

Serum beta2-microglobulin level in systemic lupus erythematosus patients: Relation to disease activity

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