Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China.
Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, 610041, China.
Int J Cardiovasc Imaging. 2021 Jul;37(7):2197-2205. doi: 10.1007/s10554-021-02201-7. Epub 2021 Mar 4.
Systemic lupus erythematosus (SLE) often leads to various cardiovascular diseases. We aimed to investigate the value of peak strain dispersion (PSD) in evaluating left ventricular dysfunction in patients with uncomplicated SLE. Eighty-seven female SLE patients and fifty-nine healthy female controls were recruited. The SLE patients were divided into inactive disease (SLE disease activity index (SLEDAI) ≤ 4; n = 48) and active disease (SLEDAI ≥ 5; n = 39) subgroups. Traditional echocardiography and two-dimensional speckle-tracking echocardiography were performed using a GE VividE9 ultrasound diagnostic system and an advanced quantitative analysis EchoPAC workstation (version 201), respectively. The global longitudinal strain (GLS) in the SLE with SLEDAI ≤ 4 group was comparable to that in the control group (- 19.89% vs - 20.7%; P = 0.061). However, GLS was obviously damaged in the SLE with SLEDAI ≥ 5 group compared with that in the control group (- 19.07% vs - 20.7%; P < 0.001). PSD impairment was observed in the SLE with SLEDAI ≤ 4 group (33.83 ms vs 31.44 ms; P = 0.012) and SLE with SLEDAI ≥ 5 groups (52.31 ms vs 31.44 ms; P < 0.001), but the largest difference was observed in the active disease group. Linear regression analysis showed that PSD was moderately correlated with the SLEDAI (r = 0.535; P < 0.001) in SLE patients with SLEDAI ≤ 4 and showed the best correlation with the SLEDAI (r = 0.646; P < 0.001) in the SLE patients with SLEDAI ≥ 5. A correlation between GLS and the SLEDAI (r = 0.359; P = 0.025) was found in the active disease group but not in the inactive disease group (r = 0.253; P = 0.082). PSD is more comprehensive and accurate for evaluating left ventricular subclinical dysfunction in SLE patients. In inactive SLE patients, PSD is a more sensitive index to evaluate early systolic dysfunction of the left ventricle. GLS may be a more vulnerable indicator of early left ventricular cardiac dysfunction in active SLE patients. Controlling disease activity may reduce the events of cardiac dysfunction.
系统性红斑狼疮（SLE）常导致各种心血管疾病。我们旨在研究峰应变离散度（PSD）在评估无并发症 SLE 患者左心室功能障碍中的价值。招募了 87 名女性 SLE 患者和 59 名健康女性对照者。将 SLE 患者分为无活动疾病（SLE 疾病活动指数（SLEDAI）≤4；n=48）和活动疾病（SLEDAI≥5；n=39）亚组。使用 GE VividE9 超声诊断系统和二维斑点追踪超声心动图分别进行传统超声心动图和二维斑点追踪超声心动图检查，并使用高级定量分析 EchoPAC 工作站（版本 201）。SLEDAI≤4 组的 SLE 患者的整体纵向应变（GLS）与对照组相似（-19.89% vs -20.7%；P=0.061）。然而，与对照组相比，SLEDAI≥5 组的 SLE 患者的 GLS 明显受损（-19.07% vs -20.7%；P<0.001）。SLEDAI≤4 组（33.83ms vs 31.44ms；P=0.012）和 SLEDAI≥5 组（52.31ms vs 31.44ms；P<0.001）中观察到 PSD 损害，但在活动疾病组中观察到的差异最大。线性回归分析显示，在 SLEDAI≤4 的 SLE 患者中，PSD 与 SLEDAI 中度相关（r=0.535；P<0.001），在 SLEDAI≥5 的 SLE 患者中与 SLEDAI 相关性最佳（r=0.646；P<0.001）。在活动疾病组中发现 GLS 与 SLEDAI 之间存在相关性（r=0.359；P=0.025），而在非活动疾病组中未发现相关性（r=0.253；P=0.082）。PSD 更全面、准确地评估 SLE 患者左心室亚临床功能障碍。在无活动 SLE 患者中，PSD 是评估左心室收缩早期功能障碍的更敏感指标。GLS 可能是活动 SLE 患者左心室早期心功能障碍的更敏感指标。控制疾病活动可能会减少心脏功能障碍的发生。
