Abstract
Abstract Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized with high cardiovascular morbidity and mortality. However, cardiac involvement, especially at an early stages of the disease is largely underdiagnosed due to non-specific nature of the symptoms and low sensitivity of current diagnostic tools such as 2D conventional echocardiography derived left ventricular ejection fraction (LVEF), on the other hand, speckle tracking echocardiography (STE) derived left ventricular global longitudinal strain (LV GLS) has shown to be a reliable and sensitive tool for the diagnosis of subtle myocardial changes in various entities. Purpose The present study aimed to perform an extensive systemic review and meta-analysis of the current case-control studies based on the assessment of the left ventricular systolic function with standard and advanced echocardiographic methods. Methods The objectives, literature search strategies, inclusion and exclusion criteria, outcome measurements, and methods of statistical analysis were analyzed according to an established protocol of the cochrane collaboration steps and meta-analysis of observational studies in epidemiology recommendations (MOOSE). Results A total of 825 papers were collected according to our searching criteria, of those 20 studies including 1121 SLE patients and 1010 controls with evaluated LVEF and 8 studies including 387 patients and 283 controls with evaluated LV GLS were selected. We found, that overall patients with SLE exhibited lower levels of LVEF [weighted mean difference -WMD (95%CI) 0.336 (−0.423 to −0.248); p<0.001] (Fig. 1), although separately some included studies showed that the difference in terms of LVEF between SLE and the control group is not always significant. LV GLS was significantly lower in SLE patients as compared to controls [WMD (95%CI) −1.341 (−1.517 to −1.166); p<0.001] (Fig. 1), LV GLS was unequivocally lower in SLE patients (Fig. 2) in every reported study, moreover some studies showed significant association between deteriorated LV GLS and cardiovascular events. Conclusions LV systolic function as measured by LVEF and LV GLS is significantly affected in SLE patients. Data from meta-analysis suggest that STE derived LV GLS assessment potentially represents a new tool to improve precise and early assessment of LV function and may improve risk-stratification in patients with SLE. Funding Acknowledgement Type of funding sources: None.
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call