Subclinical right ventricle systolic dysfunction in childhood-onset systemic lupus erythematosus: insights from two-dimensional speckle-tracking echocardiography

Leal, Gabriela Nunes; Silva, K F; França, Camila M.P.; Lianza, Alessandro Cavalcanti; Andrade, José L.; Campos, Lúcia Maria Arruda; Bonfá, Eloísa; Silva, C A

doi:10.1177/0961203314563135

Cited by 38 publications

(30 citation statements)

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“…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].…”

Section: Systolic Functionmentioning

confidence: 95%

Echocardiography in the Assessment of Patients with Rheumatologic Diseases

Al-Mohaissen

Chan

2016

Curr Cardiol Rep

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Cardiovascular disease is an important extra-articular manifestation of rheumatologic diseases leading to considerable mortality and morbidity. Echocardiography emerges as a useful non-invasive technique for the screening and evaluation of cardiac involvement in these patients. With the technological advancement in echocardiographic techniques, we have gained a greater appreciation of the prevalence and nature of the cardiac involvement in these patients, as detection of subclinical disease is increasingly feasible. This review discusses cardiac involvement in patients with rheumatoid arthritis, systemic lupus erythematosus, anti-phospholipid antibody syndrome, systemic sclerosis and ankylosing spondylitis, and the role of different echocardiographic modalities in their evaluation.

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Section: Systolic Functionmentioning

confidence: 95%

Echocardiography in the Assessment of Patients with Rheumatologic Diseases

Al-Mohaissen

Chan

2016

Curr Cardiol Rep

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“…The current study confirmed these data for positive aCL antibod- The current study revealed that right ventricular function was more impaired than left ventricular function, similar to findings by Tektonidou et al (19) who declared that all parameters of RV diastolic function showed more pronounced impairment than the respective LV parameters. This dissociation may reflect a preferential involvement or a higher susceptibility of the right ventricle, which can emphasize the role of microvascular disease in the RV more than in the LV, due to its smaller mass than the LV (27); pulmonary hypertension may also have a role (20,27). In that context, pulmonary hypertension and primary APS were the strongest independent predictors of a prolonged duration time.…”

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confidence: 87%

The implication of tissue Doppler echocardiography and cardiopulmonary exercise in early detection of cardiac dysfunction in systemic lupus erythematosus patients

Elnady

et al. 2016

Eur J Rheumatol

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Objective: Systemic lupus erythematosus (SLE) can present limitations to exercise capacity and quality of life (QoL) because of various clinical conditions, such as pulmonary disease or heart disease. Tissue Doppler echocardiography (TDE) offers the promise of an objective measurement to quantify regional and global ventricular function through the assessment of myocardial velocity data. This study aimed to assess the intensity of left ventricular (LV) and right ventricular (RV) systolic and diastolic dysfunction in SLE patients by means of TDE and cardiopulmonary exercise (CPX) testing to determine their impact on QoL.Material and Methods: Overall, 56 SLE patients within two tertiary healthcare centers as well as 50 healthy controls were examined with TDE after the exclusion of cardiovascular risk factors. TDE was performed for maximal systolic (S), early diastolic (E`), and late diastolic (A`) velocities of the mitral and tricuspid annulus. Pulsed wave (PW) Doppler of mitral and tricuspid valve inflow was performed in addition to the estimation of the left ventricle ejection fraction and assessment of right ventricle systolic function by tricuspid annular plane systolic excursion (TAPSE). Disease activity was assessed by the Systemic Lupus Activity Measure (SLAM), and the damage index was assessed by the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI). CPX tests according to the modified Bruce protocol were performed.Results: SLE patients in both subgroups had more or less similar laboratory data and statistically higher values of ESR, CRP, and anticardiolipin (aCL) antibodies compared to the control group. LV function showed statistically insignificant EF compared to the control group, being lower in the patient group. Tissue Doppler image revealed that E` and A` of the mitral annulus were lower in the patient group than in the control group. Concerning RV, TAPSE in the patient group was statistically lower than in the control group, and there was a statistical difference between SLE groups Ia and Ib; also, S wave was lower in group Ib than in group Ia. RV diastolic dysfunction in the form of lower E` and A` values was observed for the SLE group compared to the control group, especially in the medial annulus of the tricuspid valve. A higher A wave velocity with PWD of mitral and tricuspid inflows was observed in the patient group compared to the control group.Conclusion: SLE patients have an increased prevalence of subclinical systolic and diastolic LV and RV dysfunction. This result advocates for regular follow-up and early screening of SLE patients. Accordingly, treatment focused on improving diastolic heart function may have a role in enhancing QoL and improving the prognosis of SLE patients.

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“…Pulmonary artery hypertension is a rare but severe complication of SLE . The mechanism of PAH in SLE is dormant, but it progresses rapidly in that many patients are clinically silent: that is, without manifestations of SLE activity . According to literature reports, the incidence of PAH in patients with SLE has gradually increased in recent years, and it would increase with lengthening of the disease duration.…”

Section: Discussionmentioning

confidence: 99%