Tingting Luo1, Zhenhua Wang2, Zhen Chen3, Ermei Yu1, Chenglong Fang3. 1. Department of Echocardiography, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China. 2. Department of Cardiology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China. 3. Department of Rheumatology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Abstract
BACKGROUND: Layer-specific speckle-tracking echocardiography (STE) is a noninvasive approach that assesses subclinical left ventricular dysfunction. We aimed to investigate the (I) alteration of layer-specific STE parameters and the dyssynchrony index; and (II) the disease parameters associated with layer-specific STE change in drug-naïve patients with new-onset systemic lupus erythematosus (SLE) without cardiac symptoms. METHODS: Thirty-five drug-naïve patients with new-onset SLE and twenty-five healthy controls were enrolled. All individuals received both conventional echocardiographic and two-dimensional STE assessment. The data of layer-specific global longitudinal strain (GLS), global circumferential strain (GCS), and peak systolic dispersion (PSD) were acquired in layer-specific STE. RESULTS: All patients had a normal left ventricular ejection fraction (LVEF)(mean LVEF: 58%) and conventional echocardiographic parameters were comparable between patients and controls. Decreased layer-specific GLS and elevated PSD were observed in SLE patients (whole layer GLS: -17.6%±3.0% versus -19.3%±2.6%, P=0.02; endocardial GLS: -20.0%±3.2% versus -22.1%±3.0%, P=0.01; epicardial GLS: -15.6%±2.7% versus -16.8%±2.4%, P=0.04; PSD: 41.0±18.9 versus 28.8±10.1 msec, P=0.007). In contrast, there was no difference in layer-specific GCS at three different levels between patients and controls (P>0.05). More severely impaired GLS was observed in patients with higher disease activity, high-risk antiphospholipid antibody (aPL) profile, or renal involvement. The PSD was increased in patients with higher disease activity or a high-risk aPL profile. Correlational analysis showed that GLS at three layers and PSD correlated with high-sensitivity C-reactive protein (hsCRP) levels (whole GLS: r=0.662, P<0.001; endocardial GLS: r=0.637, P<0.001; epicardial GLS: r=0.658, P<0.001; PSD: r=0.390, P=0.021). PSD correlated with epicardial GLS (r=0.360, P=0.047), when treating the hsCRP level, renal involvement, aPL profile, and disease activity as control variables. Multivariate regression showed the hsCRP level and epicardial GLS were predictors of layer-specific GLS impairment and elevated PSD, respectively. CONCLUSIONS: Drug-naive patients with new-onset SLE are likely to have subclinical GLS impairment and left ventricular dyssynchrony, even in the presence of normal LVEF. SLE-related risk factors are associated with these dysfunctions. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
BACKGROUND: Layer-specific speckle-tracking echocardiography (STE) is a noninvasive approach that assesses subclinical left ventricular dysfunction. We aimed to investigate the (I) alteration of layer-specific STE parameters and the dyssynchrony index; and (II) the disease parameters associated with layer-specific STE change in drug-naïve patients with new-onset systemic lupus erythematosus (SLE) without cardiac symptoms. METHODS: Thirty-five drug-naïve patients with new-onset SLE and twenty-five healthy controls were enrolled. All individuals received both conventional echocardiographic and two-dimensional STE assessment. The data of layer-specific global longitudinal strain (GLS), global circumferential strain (GCS), and peak systolic dispersion (PSD) were acquired in layer-specific STE. RESULTS: All patients had a normal left ventricular ejection fraction (LVEF)(mean LVEF: 58%) and conventional echocardiographic parameters were comparable between patients and controls. Decreased layer-specific GLS and elevated PSD were observed in SLE patients (whole layer GLS: -17.6%±3.0% versus -19.3%±2.6%, P=0.02; endocardial GLS: -20.0%±3.2% versus -22.1%±3.0%, P=0.01; epicardial GLS: -15.6%±2.7% versus -16.8%±2.4%, P=0.04; PSD: 41.0±18.9 versus 28.8±10.1 msec, P=0.007). In contrast, there was no difference in layer-specific GCS at three different levels between patients and controls (P>0.05). More severely impaired GLS was observed in patients with higher disease activity, high-risk antiphospholipid antibody (aPL) profile, or renal involvement. The PSD was increased in patients with higher disease activity or a high-risk aPL profile. Correlational analysis showed that GLS at three layers and PSD correlated with high-sensitivity C-reactive protein (hsCRP) levels (whole GLS: r=0.662, P<0.001; endocardial GLS: r=0.637, P<0.001; epicardial GLS: r=0.658, P<0.001; PSD: r=0.390, P=0.021). PSD correlated with epicardial GLS (r=0.360, P=0.047), when treating the hsCRP level, renal involvement, aPL profile, and disease activity as control variables. Multivariate regression showed the hsCRP level and epicardial GLS were predictors of layer-specific GLS impairment and elevated PSD, respectively. CONCLUSIONS: Drug-naive patients with new-onset SLE are likely to have subclinical GLS impairment and left ventricular dyssynchrony, even in the presence of normal LVEF. SLE-related risk factors are associated with these dysfunctions. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Authors: Sherif F Nagueh; Otto A Smiseth; Christopher P Appleton; Benjamin F Byrd; Hisham Dokainish; Thor Edvardsen; Frank A Flachskampf; Thierry C Gillebert; Allan L Klein; Patrizio Lancellotti; Paolo Marino; Jae K Oh; Bogdan Alexandru Popescu; Alan D Waggoner Journal: J Am Soc Echocardiogr Date: 2016-04 Impact factor: 5.251
Authors: Marcus Carlsson; Einar Heiberg; Ellen Ostenfeld; Katarina Steding-Ehrenborg; Sándor J Kovács; Frank Flachskampf; Håkan Arheden Journal: J Am Coll Cardiol Date: 2018-01-16 Impact factor: 24.094
Authors: Angela Tincani; Michael M Ward; Maria G Tektonidou; Laura Andreoli; Marteen Limper; Zahir Amoura; Ricard Cervera; Nathalie Costedoat-Chalumeau; Maria Jose Cuadrado; Thomas Dörner; Raquel Ferrer-Oliveras; Karen Hambly; Munther A Khamashta; Judith King; Francesca Marchiori; Pier Luigi Meroni; Marta Mosca; Vittorio Pengo; Luigi Raio; Guillermo Ruiz-Irastorza; Yehuda Shoenfeld; Ljudmila Stojanovich; Elisabet Svenungsson; Denis Wahl Journal: Ann Rheum Dis Date: 2019-05-15 Impact factor: 19.103
Authors: S Bernatsky; J-F Boivin; L Joseph; S Manzi; E Ginzler; D D Gladman; M Urowitz; P R Fortin; M Petri; S Barr; C Gordon; S-C Bae; D Isenberg; A Zoma; C Aranow; M-A Dooley; O Nived; G Sturfelt; K Steinsson; G Alarcón; J-L Senécal; M Zummer; J Hanly; S Ensworth; J Pope; S Edworthy; A Rahman; J Sibley; H El-Gabalawy; T McCarthy; Y St Pierre; A Clarke; R Ramsey-Goldman Journal: Arthritis Rheum Date: 2006-08
Authors: Marat Fudim; Mouhammad Fathallah; Linda K Shaw; Peter R Liu; Olga James; Zainab Samad; Jonathan P Piccini; Paul L Hess; Salvador Borges-Neto Journal: JACC Cardiovasc Imaging Date: 2018-07-18
Authors: Mary J Roman; Mary K Crow; Michael D Lockshin; Richard B Devereux; Stephen A Paget; Lisa Sammaritano; Daniel M Levine; Adrienne Davis; Jane E Salmon Journal: Arthritis Rheum Date: 2007-10
Authors: Adam C Labonte; Brian Kegerreis; Nicholas S Geraci; Prathyusha Bachali; Sushma Madamanchi; Robert Robl; Michelle D Catalina; Peter E Lipsky; Amrie C Grammer Journal: PLoS One Date: 2018-12-18 Impact factor: 3.240