Subclinical left ventricular dysfunction in childhood-onset systemic lupus erythematosus: a two-dimensional speckle-tracking echocardiographic study

Abstract

2DST echocardiography has identified subclinical LV deformation impairment in c-SLE patients. Disease activity and cumulative exposure to CRFs contribute to myocardial compromise.

Echocardiography in the Assessment of Patients with Rheumatologic Diseases

“…In a study involving patients with childhood SLE and normal EF on 2D-TTE [48], reduction in all parameters of LV longitudinal and radial deformation was demonstrated compared to controls. LV peak longitudinal systolic strain correlated negatively with SLE disease activity index and cumulative exposure to traditional and diseaserelated CV risk factors [48]. Abnormalities in RV strain have also been reported [11].…”

“…Diastolic dysfunction has been reported in up to 72 % of patients with SLE and has been linked to disease duration, but not to disease activity [12,48,49]. Patients with SLE and long disease duration have higher rates of impaired ventricular relaxation based on reduced transmitral E/A ratio, prolonged isovolumetric relaxation time and lower E′/A′ ratio compared to those with short disease duration [50].…”

What are the benefits of two-dimensional speckle tracking echocardiography for diagnosis and treatment follow-up of childhood-onset systemic lupus erythematosus myocarditis?

“…6,7 2DST deformation analysis has also been proven as a valuable echocardiographic tool for detection of subclinical myocardial compromise in a wide range of diseases, with undoubted prognostic and therapeutic implications. 8 Although negative correlation between SLEDAI-2K and LV longitudinal peak systolic strain has already been documented by transversal studies in c-SLE patients with no signs or symptoms of heart failure, 7 no prospective study has ever documented LV myocardial deformation pattern of patients throughout as well as in-between flares.…”

Organ involvement other than lupus nephritis in childhood-onset systemic lupus erythematosus

“…12 Improved ECHO technology has discovered subclinical left and right ventricular dysfunction in cSLE. 50,51 Likewise, there is a large body of literature demonstrating frequent Pulmonary Function Test (PFT) abnormalities in cSLE, even in the absence of clinically or radiographically apparent pulmonary disease, with no discernible progression. 4 The role of PFTs without clinical or radiographic changes is thus unclear, though the abnormalities observed continue to hint at subclinical pathology.…”