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一项使用左心房自动功能成像技术评估狼疮性肾炎患者左心房功能的研究。

A study on the evaluation of left atrial function in lupus nephritis patients using left atrial automated functional imaging technology.

作者信息

Zhang Jing, Ye Yanyan, Huang Xu, Ding Yan, Li Xia, Zhang Chunquan

机构信息

Department of Ultrasound, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.

出版信息

Lupus. 2025 Aug;34(9):888-898. doi: 10.1177/09612033251346342. Epub 2025 Jun 10.

DOI:10.1177/09612033251346342
PMID:40492848
Abstract

ObjectivesEmploying advanced left atrial automated functional myocardial imaging technology to investigate whether patients with lupus nephritis (LN) experience more severe cardiac impairment compared to extra-renal systemic lupus erythematosus (extra-renal SLE) patients, while also identifying the primary risk factors affecting left atrial reservoir strain (LASR) in LN patients.MethodsRoutine echocardiographic evaluations were performed on patients with lupus nephritis (LN), Extra-renal systemic lupus erythematosus (SLE), and healthy controls. The left atrial automated functional imaging (AFILA) technique was employed to measure LASR, left atrial conduit strain (LASCD), and left atrial contraction strain (LASCT) for all study participants. Demographic characteristics of all participants were collected, along with clinical and laboratory features for the case group.ResultsWe included 42 healthy controls, 91 patients with extra-renal SLE, and 79 patients with LN. LASR, LASCD, and LASCT in the LN group were all significantly lower than those in the extra-renal SLE group and the control group, with the extra-renal SLE group also exhibiting lower values than the control group (LASR: 22.00% vs 27.00% vs 36.00%, < .001; LASCD: -14.00% vs -17.00% vs -24.00%, < .001; LASCT: -9.00% vs -10.00% vs -14.00%, < .001). A multiple regression analysis of LASR in the LN group indicated that triglycerides (TG) were the sole laboratory indicator independently associated with it (β[SE]: -1.025 [0.370], = .007).ConclusionsThe degree of LA involvement in patients with LN was significantly greater than in those with extra-renal SLE, with TG potentially serving as the only laboratory indicator capable of effectively predicting LASR. Furthermore, AFILA technology demonstrates considerable potential for the early identification of subclinical myocardial damage.

摘要

目的

运用先进的左心房自动功能心肌成像技术,研究狼疮性肾炎(LN)患者与肾外系统性红斑狼疮(肾外SLE)患者相比是否存在更严重的心脏损害,同时确定影响LN患者左心房储备应变(LASR)的主要危险因素。

方法

对狼疮性肾炎(LN)患者、肾外系统性红斑狼疮(SLE)患者和健康对照者进行常规超声心动图评估。采用左心房自动功能成像(AFILA)技术测量所有研究参与者的LASR、左心房管道应变(LASCD)和左心房收缩应变(LASCT)。收集所有参与者的人口统计学特征以及病例组的临床和实验室特征。

结果

我们纳入了42名健康对照者、91名肾外SLE患者和79名LN患者。LN组的LASR、LASCD和LASCT均显著低于肾外SLE组和对照组,肾外SLE组的值也低于对照组(LASR:22.00%对27.00%对36.00%,P<0.001;LASCD:-14.00%对-17.00%对-24.00%,P<0.001;LASCT:-9.00%对-10.00%对-14.00%,P<0.001)。对LN组LASR的多元回归分析表明,甘油三酯(TG)是与之独立相关的唯一实验室指标(β[标准误]:-1.025[0.370],P=0.007)。

结论

LN患者左心房受累程度显著高于肾外SLE患者,TG可能是唯一能够有效预测LASR的实验室指标。此外,AFILA技术在早期识别亚临床心肌损伤方面显示出巨大潜力。

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