Key result
Systemic lupus erythematosus was associated with subclinical right ventricular systolic dysfunction, including lower ejection fraction and longitudinal strain (both p < 0.0001) compared to controls.
Why the study?
Subclinical right ventricular alterations in systemic lupus erythematosus without concomitant cardiac disease are not well characterized using three-dimensional echocardiography.
Do patients with uncomplicated systemic lupus erythematosus have subclinical right ventricular alterations detectable by three-dimensional echocardiography compared to healthy controls?
Case-Control (n=100)
Do patients with uncomplicated systemic lupus erythematosus have subclinical right ventricular alterations detectable by three-dimensional echocardiography compared to healthy controls?
p-value: p=<0.0001
Three-dimensional echocardiography can detect subclinical right ventricular systolic dysfunction in patients with uncomplicated SLE, which correlates with cumulative disease damage.
3D echocardiography may detect subclinical RV dysfunction in uncomplicated SLE; extends imaging data but leaves open prognostic and therapeutic implications.
Our aim was to identify subclinical right ventricular (RV) alterations in systemic lupus erythematosus (SLE) by combining standard and three-dimensional echocardiography (3DE). Fifty SLE patients without concomitant cardiac disease and 50 healthy controls, matched for age and gender, were enrolled. Disease damage was evaluated by inflammatory markers and SLE damage index. All patients underwent an echo-Doppler examination with 3DE assessment of RV function, RV septal and lateral longitudinal strain. The two groups had comparable body mass index and blood pressure. RV transversal middle diameter and pulmonary arterial pressure were significantly higher in SLE compared to controls. By 3DE, RV end-systolic volume ( p = 0.037) was greater, whereas stroke volume ( p = 0.023), ejection fraction ( p < 0.0001) and septal and lateral longitudinal strain (both p < 0.0001) were lower in SLE. SLE damage index ≥ 1 was negatively associated with tricuspid annular plane systolic excursion (TAPSE) ( p < 0.002), tricuspid E/A ratio ( p = 0.003), RV ejection fraction ( p < 0.05), lateral longitudinal strain ( p < 0.0001) and septal longitudinal strain ( p = 0.04). By separate multivariate models, after adjusting for age, C reactive protein and proBNP, SLE damage index was independently associated with TAPSE ( p = 0.009) and RV lateral longitudinal strain ( p = 0.007). In conclusion, a subclinical RV systolic dysfunction is detectable in SLE by 3DE, RV lateral wall strain being a key parameter. RV dysfunction is associated with cumulative disease damage.
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Buonauro et al. (2019) conducted a case-control in Systemic lupus erythematosus (n=100). Systemic lupus erythematosus vs. Healthy controls was evaluated on Right ventricular ejection fraction and longitudinal strain by 3DE (p=<0.0001). Systemic lupus erythematosus was associated with subclinical right ventricular systolic dysfunction, including lower ejection fraction and longitudinal strain (both p < 0.0001) compared to controls.
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