Evaluation Of Left Ventricular Longitudinal Two-dimensional Strain In Patients With Systemic Lupus Erythematosus Measured By Speckle Tracking Echocardiography

Background Systemic Lupus Erythematosus (SLE) is an autoimmune disease, can affect every systems and organs in the body,and Often involves the cardiovascular system. Although lacking of clinical symptoms early, there are cardiac functional changes, which change as the condition changes and can jeopardize the patient's life in severe case.Therefore, Correct evaluation of cardiac function in patients with SLE is very significant to diagnosis, evaluation of clinical treatment and prognosis.Speckle tracking imaging (STI)is a newly developed quantitative technology in Echocardiography,the technology uses speckle tracking principle to track the speckles in high frame rate two-dimensional image, to calculation and description the velocity and strain of myocardial, to reflect the state of myocardial function. This technology is angle-independent, repeatable, more accurate, and objective to quantitative global and regional myocardial wall strain of left ventricle.Objection To investigate the value of STI in quantifying global and regional myocardial strain in normal group and SLE group,and to analyze the statistical correlations between GLS-Avg and left ventricular ejection fraction (LVEF),age,duration of illness.Methodsâ‘ sixty subjects were divided into two groups. Group A consisted of twenty-four normal subjects, and group B included thirty patients with SLE. High frame rate two-dimensional images were recorded from the apical Two-chamber view, long-axis view and four-chamber view of the left ventricle (LV). Peak systolic strain and global peak systolic strain of each view of Eighteen segment were measured by automated functional imaging(AFI) software of 2-DSE. Compare all parameters.â‘¡According to Biplane Simpson's to measure LVEF,The statistical correlations between LVEF, age, duration of illness and GLS-Avg were analyzed.â‘¢10 cases were randomly taken from the normal group,The same observer at different times and two observers respectively measure the strain of left ventricular and analysis of its relevance.Results Left ventricular two-dimensional longitudinal strain gradually increased from the base to apex in group A. There are statistically differences between the apical segments and the basal, middle segments of every left ventricular wall (P<0.05);the time to peak-tw of every segments is consistent. Left ventricular two-dimensional longitudinal strain gradually increased from the base to apex in group B,except anteroseptal and anterior wall,There was no statistically significant difference between the apical segments and the basal, middle segments of every left ventricular wall (P>0.05);All parameters of S,GLS-A2C,GLS-LAX,GLS-A4C and GLS-Avg were significantly higher in group A than those in group B,There are statistically differences (P<0.05);the time to peak-tw of every segments is not consistent.The GLS-Avg statistically correlated with LVEF,and didn't statistically correlated with age and duration of illness. The same observer at different times and two observers' Left ventricular strain measurements has a good statistical correlation.Conclusions The early reduce of left ventricular global and regional myocardial strain could be detected rapidly and precisely by STI,This suggested that myocardial infarction existented in SIE.STI has a potential as an important,angle-independent,repeatable technique in evaluating the degree of affected myocardium and observing the changes of condition in patients with SLE.