Early left ventricular remodeling and subclinical cardiac dysfunction in systemic lupus erythematosus: a three-dimensional speckle tracking study.

The article aimed to detect the early cardiac dysfunction in patients with systemic lupus erythematosus (SLE) and predict the relationships between the strain parameters and the disease activities. Three-dimensional speckle-tracking echocardiography was performed to measure left ventricular (LV) structures and global strains on 63 subjects (41 SLE patients with preserved EF and 22 healthy controls). The SLE disease activity was assessed using the SLE Disease Activity Index (SLEDAI), and all the SLE patients were further divided into two subgroups according to disease severity. SLEDAI scores 0-8 were defined as group A, 9-20 were defined as group B. Results indicated that all components of left ventricle global strain [global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS)] were significantly reduced in SLE patients. GLS, GRS, GCS had positive correlation with LVEF respectively (r = 0.619, 0.845, 0.91, absolute value, all P < 0.05). The E/e', LVEDVI, LVESVI, LVM, LVMI were increased in all SLE patients (all P < 0.05). In subgroups, GLS and GRS were decreased in group B. Multiple linear regressions analysis indicate that the SLEDAI score was a predictive factor for damage of GLS and GRS. These results indicate that myocardial damage and LV remodeling still occur in SLE patients even with normal EF. The severe disease activity followed with worsening myocardial injury. SLE disease activity might be a potential driver of LV damages.