Why the study?
To investigate whether patients with lupus nephritis experience more severe cardiac impairment compared to extra-renal systemic lupus erythematosus patients, and to identify primary risk factors affecting left atrial reservoir strain.
Does left atrial automated functional imaging reveal more severe cardiac impairment in lupus nephritis patients compared to extra-renal SLE patients and healthy controls?
Does left atrial automated functional imaging reveal more severe cardiac impairment in lupus nephritis patients compared to extra-renal SLE patients and healthy controls?
Left atrial automated functional imaging demonstrates that patients with lupus nephritis have significantly greater left atrial impairment compared to those with extra-renal SLE, with triglycerides independently associated with reduced left atrial reservoir strain.
LN may link to greater LA impairment than extra-renal SLE; hypothesis-generating and requires prospective validation before clinical adoption.
Objectives Employing 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. Methods Routine 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. Results We 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%, p < .001; LASCD: −14.00% vs −17.00% vs −24.00%, p < .001; LASCT: −9.00% vs −10.00% vs −14.00%, p < .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], p = .007). Conclusions The 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.
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Zhang et al. (2025) studied this question.
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