Key result
GMPI parameters SMS and STS are linked to NT-proBNP levels in asymptomatic SLE patients.
Why the study?
Myocardial involvement is a leading cause of death in SLE patients, but symptomatic cases are fewer than expected from autopsy studies, necessitating better noninvasive assessment methods.
Does Technetium-99m-sestamibi gated myocardial perfusion imaging correlate with NT-proBNP levels to assess myocardial involvement in asymptomatic patients with systemic lupus erythematosus?
Cross-Sectional (n=30)
Does Technetium-99m-sestamibi gated myocardial perfusion imaging correlate with NT-proBNP levels to assess myocardial involvement in asymptomatic patients with systemic lupus erythematosus?
p-value: p=<0.001
Tc-MIBI gated myocardial perfusion imaging parameters correlate with NT-proBNP levels, providing a potential non-invasive method to detect subclinical myocardial involvement in SLE patients.
GMPI may reveal subclinical myocardial defects in asymptomatic SLE; leaves open whether imaging alters management or outcomes.
BACKGROUND: In patients with systemic lupus erythematosus (SLE), myocardial involvement is the third leading course of death after lupus nephropathy (LN) and infections. Previous autopsy studies have demonstrated a high incidence of cardiovascular abnormalities in the myocardium. However, the patients with typical symptoms are far much fewer than expected from post-mortem examinations. OBJECTIVES: Tc-MIBI) gated myocardial perfusion imaging (GMPI) characteristics of lupus patients without cardiovascular symptoms, and the relationships between GMPI characteristics and biochemical markers of myocardial injury, and to explore the role of GMPI in assessing myocardial involvement. METHODS: Thirty patients were studied with rest myocardial perfusion imaging, and summed rest score (SRS), summed motion score (SMS), and summed thickening score (STS) were calculated automatically. Biomarkers, including N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and creatine-kinase-MB (CK-MB), were detected simultaneously. GMPI parameters, LV functions and biomarkers were compared between two NT-proBNP groups. The relationships between these parameters were studied by correlation analysis. RESULTS: SMS, STS, and glomerular filtration rate (eGFR) were the main influencing factors of NTproBNP level (p = 0.001, <0.001, 0.042, respectively). Thirteen patients with an evaluated concentration of NT-proBNP had the lower left ventricular ejection fraction (LVEF), peak filling rate (PFR), eGFR and higher levels of CK-MB (in all comparisons, p < 0.05), and SRS was the only influencing factor of NT-proBNP (p = 0.007). Within thirteen patients with SRS≥2, there was a significant correlation between SRS and NT-proBNP (p < 0.001). CONCLUSION: Tc-MIBI GMPI could evaluate the left ventricular function and prompt the cardiomyocyte function at the cellular level. SMS and STS were the main influencers for plasma NT-proBNP, and SRS was the independent factor for elevated NT-proBNP. This radionuclide imaging method could provide additional diagnostic information on myocardial involvement in patients with SLE.
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Shao et al. (2022) conducted a cross-sectional in Systemic lupus erythematosus (SLE) (n=30). Tc-MIBI gated myocardial perfusion imaging (GMPI) was evaluated on NT-proBNP level (p=<0.001). In SLE patients without cardiovascular symptoms, GMPI parameters SMS and STS were the main influencers for plasma NT-proBNP (p=0.001 and p<0.001, respectively).
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