Non-invasive evaluation of early myocardial injury in systemic lupus erythematosus patients:a combined analysis of longitudinal strain,peak dispersion and left ventricular pressure-strain loop technology
LIU Suijuan
WU Haiyan
ZHOU Liang
JIANG Xiaoli
LI Wen
Abstract：Objective To explore the application value of global longitudinal strain(GLS)and peak strain dispersion(PSD)combined with left ventricular pressure strain loop(PSL)technology in the early diagnosis of myocardial injury in systemic lupus erythematosus(SLE)patients.Methods We selected 74 SLE patients hospitalized at Yunnan 1st People Hospital from August 2022 to July 2024,all undergoing cardiac ultrasound examinations.Exclude 5 patients who were unable to complete the analysis due to poor image quality.Additionally,69 patients were graded and grouped based on the SLEDAI-2K score.Divided into group A with 22 cases(basically inactive and mildly inactive,score<9),group B with 21 cases(moderate activity,score 10-14),and group C with 26 cases(severe activity,score≥15),36 outpatient health examiners were selected as the normal control group D,for statistical analysis of clinical baseline data and related echocardiographic measurement parameters.Results It showed a declining trend in GLS and an increasing trend in PSD among the four groups,with statistically significant differences(P<0.05)observed in groups B and C.GWE decreased among the four groups,while GWW,GNW and GSWW increased,with statistically significant differences(P<0.05)observed in groups B and C;Correlation analysis showed that GLS was negatively correlated with LVEF(r=-0.274,P<0.05);GWE,GWI,GCW,GPW,GSCW were negatively correlated with GLS(r=-0.584,-0.451,-0.431,-0.404,-0.428,P<0.05),while GWW,GNW,GSWW was positively correlated with GLS(r=0.390,0.221,0.362,P<0.05).GWE was negatively correlated with PSD(r=-0.621,P<0.05),while GWW,GNW,GSWW were positively correlated with PSD(r=0.567,0.264,0.442,P<0.05).Comparison of myocardial contraction function parameters between the SLE group(group A+B+C)and D group,showed that there was a statistically significant difference(P<0.05)between the two groups in terms of LVEF,GLS,PSD,GWE,GWI,GWW,GNW and GSWW.The AUC of GLS,PSD,GWE,GWW,GNW,and GSWW were 0.841,0.714,0.841,0.763,0.725 and 0.740,respectively.The AUC predicted by GLS,PSD and left ventricular PSL parameters GWE,GWW,GNW and GSWW was the highest(0.913),with a sensitivity of 85%and specificity of 96%.Conclusion Echocardiographic measurements using GLS and PSD combined with PSL parameters could be used to assess early myocardial injury in SLE patients,particularly in those with moderate to severe activity,which providing new sensitive indicators for clinical diagnosis of lupus myocardial lesions.
Keywords：systemic lupus erythematosusmyocardial injuryglobal longitudinal strainpeak strain dispersionleft ventricular pressure-strain loop
Publication Date：2025-06-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 719-725 )