Deidda Martino, Noto Antonio, Firinu Davide, Piras Cristina, Cordeddu William, Depau Claudia, Costanzo Giulia, Del Giacco Stefano, Atzori Luigi, Mercuro Giuseppe, Cadeddu Dessalvi Christian
Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy.
Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy.
Metabolites. 2023 Jun 22;13(7):781. doi: 10.3390/metabo13070781.
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease, and several studies have suggested possible early RV involvement. Aim of the study was to evaluate the 3D echo parameters of the right ventricle (RV) and the metabolomic profile to correlate both with SLE severity. Forty SLE patients, free of cardiovascular disease, were enrolled and the following 3D parameters were evaluated: the RV ejection fraction (RV-EF), longitudinal strain of the interventricular septum (Septal LS), longitudinal strain of the free wall (Free-LS) and the fractional area change (FAC). In addition, a metabolomic analysis was performed. Direct correlations were observed between TAPSE values and the RV 3D parameters. Then, when splitting the population according to the SDI value, it was found that patients with higher cumulative damage (≥3) had significantly lower FAC, RV-EF, Septal LS, and Free-LS values; the latter three parameters showed a significant correlation with the metabolic profile of the patients. Furthermore, the division based on SDI values identified different metabolic profiles related to the degree of RV dysfunction. The RV dysfunction induced by the chronic inflammatory state present in SLE can be identified early by 3D echocardiography. Its severity seems to be related to systemic organ damage and the results associated with a specific metabolic fingerprint constituted by 2,4-dihydroxybutyric acid, 3,4-dihydroxybutyric acid, citric acid, glucose, glutamine, glycine, linoleic acid, oleic acid, phosphate, urea, and valine.
系统性红斑狼疮（SLE）是一种慢性炎症性疾病，多项研究表明可能早期就累及右心室（RV）。本研究的目的是评估右心室的三维超声心动图参数和代谢组学特征，以将两者与SLE的严重程度相关联。纳入了40例无心血管疾病的SLE患者，并评估了以下三维参数：右心室射血分数（RV-EF）、室间隔纵向应变（Septal LS）、游离壁纵向应变（Free-LS）和面积变化分数（FAC）。此外，还进行了代谢组学分析。观察到三尖瓣环平面收缩期位移（TAPSE）值与右心室三维参数之间存在直接相关性。然后，根据系统性红斑狼疮疾病损伤指数（SDI）值对人群进行划分时，发现累积损伤较高（≥3）的患者FAC、RV-EF、Septal LS和Free-LS值显著较低；后三个参数与患者的代谢特征显示出显著相关性。此外，基于SDI值的划分确定了与右心室功能障碍程度相关的不同代谢特征。SLE中存在的慢性炎症状态所诱发的右心室功能障碍可通过三维超声心动图早期识别。其严重程度似乎与全身器官损伤有关，并且结果与由2,4-二羟基丁酸、3,4-二羟基丁酸、柠檬酸、葡萄糖、谷氨酰胺、甘氨酸、亚油酸、油酸、磷酸盐、尿素和缬氨酸构成的特定代谢指纹相关。
