Echocardiographic assessment of asymptomatic systolic dysfunction in systemic lupus erythematosus patients

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that manifests with multiorgan inflammation. Cardiac involvement is one of the major concerns in the management of patients suffering from Systemic lupus erythematosus. The aim of our study was to assess systolic left ventricular dysfunction at a subclinical stage and to compare the obtained results with a control population using new echocardiographic imaging modalities like tissue Doppler imaging (TDI), and strain (SRI) imaging. We conducted a prospective study over a period of seven years from 2008 to 2015 in the echocardiography laboratory of the adult cardiology department of La Rabta Hospital. Our series enrolled two groups; group A: thirty patients with asymptomatic SLE and group B: thirty healthy subjects. The demographic and clinical characteristics of our patients were quite similar to those of the controls. The average age of our patients was 41 ± 8 years old. There were 25 women (83.33%) and 5 men (16.66%). There was no significant difference in the ejection fraction between the two groups. The Tei index was significantly higher than that recorded in the control group. The systolic mitral annular velocity S measured with the Doppler tissue imaging and the global longitudinal strain (GLS) were definitely lowered in the group A compared to those found in the controls (5.2 ± 0.4 cm/s vs. 8.3 ± 0.6 cm/s, P < 0.01) and (−13 ± 0.5% vs. −18 ± 0.5 cm/s, P < 0.01) ( Table 1 ). SLE is associated with a significant impairment of systolic function in patients without cardiac symptoms. Transthoracic echocardiography (TTE) associated with the new imaging modalities (TDI and SRI) can be helpful as a noninvasive diagnostic tool for early detection of subclinical myocardial disease.