Echocardiographic strain analysis reflects impaired ventricular function in youth with pediatric-onset systemic lupus erythematosus.

TitleEchocardiographic strain analysis reflects impaired ventricular function in youth with pediatric-onset systemic lupus erythematosus.
Publication TypeJournal Article
Year of Publication2020
AuthorsChang JC, Wang Y, Xiao R, Fedec A, Meyers KE, Tinker C, Natarajan SS, Knight AM, Weiss PF, Mercer-Rosa L
JournalEchocardiography
Date Published2020 Oct 03
ISSN1540-8175
Abstract

BACKGROUND: Strain analysis with speckle-tracking echocardiography shows promise as a screening tool for silent myocardial dysfunction in pediatric-onset systemic lupus erythematosus (pSLE). We compared left ventricular (LV) systolic deformation (measured by strain) in children and adolescents with pSLE to controls, and assessed the relationship between strain, disease activity, and other noninvasive measures of cardiovascular health.

METHODS: Twenty pSLE subjects ages 9-21 underwent comprehensive cardiovascular testing, including 2D speckle-tracking echocardiography, ambulatory blood pressure monitoring (ABPM), peripheral endothelial function testing, pulse wave velocity and analysis, and carotid ultrasound. Longitudinal apical-4 chamber (LS ) and midpoint circumferential strain (CS ) were compared to that of 70 healthy controls using multivariable linear regression. Among pSLE subjects, Pearson correlation coefficients were calculated to evaluate relationships between global longitudinal or circumferential strain and other measures of cardiovascular health.

RESULTS: Average SLE disease duration was 3.2 years (standard deviation [SD] 2.1). 2/20 pSLE subjects had persistent disease activity, and only one met criteria for hypertension by ABPM. LS was significantly reduced in pSLE subjects compared to controls (mean -18.3 [SD 3.2] vs -21.8% [SD 2.2], P-value <.001). There was no significant difference in CS (-24.8 [SD 3.7] vs -25.7% [SD 3.4], P = .29). Among pSLE subjects, decreased nocturnal blood pressure dipping on ABPM was associated with reduced global circumferential strain (r -0.59, P = .01).

CONCLUSIONS: Longitudinal myocardial deformation is impaired in pSLE patients despite clinical remission and may represent early myocardial damage. Strain analysis should be considered in addition to standard echocardiographic assessment during follow-up of patients with pSLE.

DOI10.1111/echo.14872
PubMed ID33009676
Grant ListUL1TR001878 / TR / NCATS NIH HHS / United States
Gary S. Gilkeson Career Development Award / / Lupus Foundation of America /
Supplement to K01-HL125521 / / Pulmonary Hypertension Association /
F32-HL142176 / HL / NHLBI NIH HHS / United States
K01-HL125521 / HL / NHLBI NIH HHS / United States