Abstract
Objective
Current echocardiography evaluation of right ventricular (RV) function, which heralds
the prognosis in patients with systemic lupus erythematosus (SLE), is of limited utility.
The non-invasive pressure–strain loop (PSL), an emerging technique, has been found
to feasible, sensitive and accurate in the diagnosis of cardiovascular diseases. The
aim of this study was to quantitatively evaluate, using the non-invasive PSL, the
right ventricular myocardial work (RVMW) in SLE patients.
Methods
Seventy-five SLE patients were recruited and grouped by pulmonary artery systolic
pressure (PASP) into normal (group A, N = 26), mild (group B, N = 22) and moderate
to severe (group C, N = 27) groups. Twenty-five healthy volunteers undergoing physical
examination were recruited as the control group. Right ventricular global myocardial
work index (RVGWI), global constructive work (RVGCW), global wasted work (RVGWW),
global work efficiency (RVGWE), global longitudinal strain (RVGLS) and other conventional
parameters were measured.
Discussion
There were no differences between group A and the control group with respect to RVLS,
RVGLS and all RVMW parameters (all p values > 0.05). RVGWI and RVGCW significantly differed among the other groups (all
p values < 0.05). RVGWE was significantly lower and RVGWW was significantly higher
in group C than in the control group and groups A and B (all p values < 0.05). Compared with the control group, RVGWW was significantly increased
and RVGLS was significantly decreased in group B (all p values < 0.05). All but one RVMW parameter moderately to strongly correlated with
SLE disease activity index (SLEDAI) and World Health Organization Functional Class
(WHO-FC). RVGWW (area under the receiver operating characteristic curve [AUC] = 0.893)
and RVGWE (AUC = 0.877) were sensitive parameters in detecting earlier cardiac dysfunction
in SLE patients.
Conclusion
RVGWW and RVGWE serve as sensitive and promising parameters in the integrative analysis
of early right ventricular dysfunction in SLE patients. To conclude, non-invasive
PSL, the novel method, facilitates the quantitative assessment of RVMW in SLE patients.
Keywords
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Article info
Publication history
Published online: February 13, 2023
Accepted:
December 17,
2022
Received in revised form:
December 8,
2022
Received:
October 23,
2022
Identification
Copyright
© 2023 Published by Elsevier Inc. on behalf of World Federation for Ultrasound in Medicine & Biology.
