Key result
Higher cumulative lupus damage is linked to impaired right ventricular function and distinct metabolic alterations.
Why the study?
Studies have suggested possible early right ventricular involvement in systemic lupus erythematosus, but evaluation using 3D echocardiography and metabolomic profiling in relation to disease severity was needed.
Does higher cumulative systemic damage correlate with right ventricular subclinical dysfunction and specific metabolomic profiles in patients with systemic lupus erythematosus?
Cross-Sectional (n=40)
No
Does higher cumulative systemic damage correlate with right ventricular subclinical dysfunction and specific metabolomic profiles in patients with systemic lupus erythematosus?
3D echocardiography can identify early right ventricular subclinical dysfunction in SLE patients, which is correlated with cumulative systemic organ damage and distinct metabolic fingerprints.
Higher SDI associated with subclinical RV impairment on 3D echo in SLE; leaves open whether metabolomic fingerprints add prognostic value.
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.
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Deidda et al. (2023) conducted a cross-sectional in Systemic lupus erythematosus (SLE) (n=40). Systemic lupus erythematosus cumulative damage (Systemic Damage Index ≥ 3) vs. Absence of cumulative systemic damage (Systemic Damage Index = 0) was evaluated on 3D echocardiographic parameters of the right ventricle (RV-EF, Septal LS, Free-LS, FAC) and correlation with metabolomic profile. Systemic lupus erythematosus patients with higher cumulative damage (SDI ≥3) had significantly lower right ventricular 3D echocardiographic parameters (FAC, RV-EF, Septal LS, Free-LS) which correlated with a distinct metabolic fingerprint.
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