Adoption of multimodal echocardiography in evaluating left ventricular systolic synchrony in patients with systemic lupus erythematosus

Abstract

Objective

it was to assess the value of multimodal ultrasound imaging technology in assessing left ventricular (LV) systolic (LVS) function in patients with systemic lupus erythematosus (SLE).

Methods

88 patients with SLE were designated as disease group (DG), and 50 healthy individuals served as control group (CG). Both groups underwent color Doppler ultrasound scanning to obtain conventional 2D echocardiography, 3D echocardiography, and 3D speckle tracking imaging (3D-STI) parameters. Spearman correlation analysis assessed the relationship between 3D-STI parameters and LV ejection fraction, and ROC curves were plotted.

Results

DG exhibited substantial differences versus CG in LV end (LVE)-diastolic volume, stroke volume, cardiac output, LVE-diastolic mass, LVE-systolic mass, and LV shortening fraction (P < 0.05). DG demonstrated greatly inferior values for 3D-STI systolic parameters, including overall LV longitudinal strain, overall LV circumferential strain, overall LV radial strain, and overall LV area strain, to CG (P < 0.05). The LV synchrony analysis revealed that, compared to the CG, the DG showed a significant increase in the peak values of longitudinal, radial, and circumferential strains in the 16th and 12th segments, the peak values of rotational angle in the 12th segment, the time differences between these values and the LV minimum systolic volume time, as well as the time to minimum systolic volume in the 16th segment (Tmsv-16) (p < 0.05). The intraclass correlation coefficient (ICC) for Tmsv-16 was 0.90, and the coefficient of variation (CV) was 4.5%, outperforming other indicators. Furthermore, the DG exhibited significantly higher levels of biomarkers, including brain natriuretic peptide (BNP), creatine kinase MB isoenzyme (CK-MB), anti-cardiac actin antibodies (anti-α-actin), and high-sensitivity C-reactive protein (hs-CRP), compared to the CG (p < 0.05). The diagnostic performance of the 3D-STI systolic parameters was as follows: overall LV longitudinal strain had sensitivity (Sen) of 85.23% and specificity (Spe) of 68%; overall LV circumferential strain had Sen of 90.91% and Spe of 78%.

Conclusion

multimodal 2D echocardiography combined with 3D echocardiography parameters offers high Sen in predicting LVS function in patients with SLE.