Early Detection of Subclinical Left Ventricular Dysfunction in Patients with Systemic Lupus Erythematosus: A Case-Control Study

Background: The aim of this study was to evaluate subclinical left ventricular (LV) dysfunction by two-dimensional (2D) speckle tracking echocardiography (STE) and three-dimensional echocardiography in patients with systematic lupus erythematosus (SLE). Methods: This case-control study was performed on 106 patients, divided into the two groups of case (53 patients with SLE) and control (53 healthy individuals). All study participants were evaluated by transthoracic echocardiography, as well as Tissue Doppler echocardiography. Accordingly, ventricular dimensions and LV ejection fraction (LVEF) were assessed. Moreover, E velocity, A velocity, E/A ratio, and E/E’ ratio were evaluated in both groups. The LV global longitudinal strain (GLS) was measured by 2D STE in all individuals. Results: There was no significant difference between the two study groups regarding LVEF based on traditional echocardiography. However, E velocity, A velocity, and the E/e’ ratio were higher in the SLE patients (P < 0.05). In addition, the anti-double-stranded DNA (anti-dsDNA) positivity in SLE patients was associated with the lower levels of LVEF. No significant correlation was found between disease duration, LVEF, and LV GLS (P > 0.05). Conclusions: Detection of subclinical LV systolic dysfunction by GLS is possible in SLE patients despite normal LVEF in traditional echocardiography. Therefore, LV could be used for the early detection and prevention of cardiac involvement in SLE patients.