Department of Ultrasound, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.
Lupus. 2024 Sep;33(10):1059-1068. doi: 10.1177/09612033241266083. Epub 2024 Jul 25.
This study aimed to assess the utility of Doppler echocardiography in evaluating left ventricular diastolic function, and prognosis in patients with systemic lupus erythematosus (SLE).
A total of 286 SLE patients were selected along with 100 age- and gender-matched healthy individuals who underwent physical examinations. Clinical baseline characteristics were collected. Various Doppler echocardiographic parameters were measured and analyzed, including left ventricular posterior wall thickness (LVPWT), interventricular septal diameter (IVSD), left ventricular mass (LVM), LVM index (LVMI), and others.
Compared to the control group, SLE patients exhibited significantly higher levels of C-reactive protein and lower levels of complement (C) 3 and C4 ( < .001). Doppler echocardiographic parameters showed significant differences between SLE patients and healthy controls, including increased LVPWT, IVSD, LVM, LVMI, peak A, PWI + Tei, E/e', TDI-Tei, and decreased e' and E/A ( < .001). Subgroup analyses indicated more severe ventricular diastolic dysfunction in patients with higher SLE activity and those who experienced cardiovascular events. Correlation analysis revealed positive associations of PWI + Tei, TDI-Tei, and GLS with SLE activity and cardiovascular events ( < .01). Multivariate logistic regression analysis identified LVMI, PWI + Tei, TDI-Tei, and GLS as significant predictors of cardiovascular events ( < .05).
Doppler echocardiography is a valuable tool for the early diagnosis of left ventricular diastolic dysfunction in SLE patients. Key echocardiographic parameters, including LVMI, PWI + Tei, TDI-Tei, and GLS, are effective in predicting cardiovascular events, underscoring the importance of comprehensive cardiac function assessments in these patients.
本研究旨在评估多普勒超声心动图在评估系统性红斑狼疮（SLE）患者左心室舒张功能和预后中的作用。
选择了 286 例 SLE 患者和 100 例年龄和性别匹配的健康体检者进行研究。收集了临床基线特征。测量并分析了各种多普勒超声心动图参数，包括左心室后壁厚度（LVPWT）、室间隔直径（IVSD）、左心室质量（LVM）、左心室质量指数（LVMI）等。
与对照组相比，SLE 患者的 C 反应蛋白水平明显升高，补体（C）3 和 C4 水平明显降低（<0.001）。SLE 患者与健康对照组的多普勒超声心动图参数存在显著差异，包括 LVPWT、IVSD、LVM、LVMI、峰值 A、PWI+Tei、E/e'、TDI-Te i、e'和 E/A 降低（<0.001）。亚组分析表明，SLE 活动度较高和发生心血管事件的患者心室舒张功能障碍更严重。相关性分析显示，PWI+Tei、TDI-Te i和 GLS 与 SLE 活动度和心血管事件呈正相关（<0.01）。多变量逻辑回归分析显示，LVMI、PWI+Tei、TDI-Te i和 GLS 是心血管事件的独立预测因子（<0.05）。
多普勒超声心动图是诊断 SLE 患者左心室舒张功能障碍的一种有价值的工具。关键的超声心动图参数，包括 LVMI、PWI+Tei、TDI-Te i和 GLS，可有效预测心血管事件，强调了对这些患者进行全面心脏功能评估的重要性。
