| ObjectiveTo analyze the changes of left atrial and left ventricular structure,left atrial function,left ventricular global myocardial systolic strain and systolic synchrony parameters in patients with systemic lupus erytnematosus(SLE)with normal left ventricular ejection fraction(LVEF>50%),and to explore the value of speckle tracking(STI)technique in evaulating left atrial function,left ventricular systolic function and systolic synchrony in patients with SLE.MethodsSixty SLE patients who met the American Rheumatism Association diagnostic criteria for SLE in 1997,had active disease and had a SLE disease activity index(SLEDAI)between 10 to 20 points and had a left ventricular ejection fraction(LVEF>50%)were selected and divided into two groups according to the duration of disease:gruop I(n=30)with diaease<5 years and group ?(n=30)with disease duration>5 years.Thrity healthy volunteers matched for sex and age with no previous history of SLE and heart disease and no significant abnormalities in electrocardiography and echocardiography were also selected as control group.The general parameter of each group:height,weight,body mass index(BMI),SLEDAI,left atrium anteroposterior diameter(LAD),left ventericular end-diastolic diameter(LVEDd),interventricular septum thickness at end-diastolic(IVSd),left ventricular posterior wall thickness at end-diastolic(LVPWd),mitral valve E/A value,LVEF measured by Simpson's method,maximum volume of left atrium(LAVmax),minimum of left atrium(LAVmin).The left atrial strain parameters:left ventricular systolic left atrial peak strain(LAs-s),left ventricular early diastolic left atrial peak strain(LAs-E),left atrial systolic left atrial peak strain(LAs-A).The left ventricular strain parameters:global longitudinal peak systolic strain(GLS),global circumferential peak systolic strain(GCS),global radial peak systolic strain(GRS)and peak strain dispersion(PSD)were compared among the three groups.Results1.There were no significant differences in age,height,weight,body mass index(BMI),SLEDAI,IVST,LVPWd,LVEDd,LVEDs,and LVEF among the three groups(P>0.05).E/A in groups ? and ? were decreased compared with control group,and the differences were stastically siginficant(P<0.05),while there was no significant difference between group ? and ?(P>0.05).LAD,LAVmax and LAVmin in group ? were significantly higher than those in group ?(P<0.05),but there was no significant difference in group I(P>0.05).2.The PSD of group? and ? were increased compared with the control group,and the PSD of group ? increased compared with the group ?,and the differences were statistically significant(P<0.05).The GLS of group ? and ? decreased compared with the control group,and the difference were statically significant(P<0.05).The GLS of group ? and ? were similar,and the differences were not statically significant(P>0.05).The GCS and GRS of group ? were decreased compared with those of group ?,and the difference were statically significant(P<0.05).The GCS and GRS of group ? were similar to those of the control group,and the difference were not statically significant(P>0.05).3.LAs-s and LAS-A in group ? were increased compared with those in group?,and the difference were statistically significant(P<0.05).LAs-s and LAS-A in group ? were decreased compared with those in the control group,and the difference were statically significant(P<0.05).LAS-E in group ? decreased compared with group?,and the differences were statically significant(P<0.05).LAS-E in group ? had no significant difference compared with the control group(P>0.05).Conclusions1.SLE patients with the course extension of the disease,left atrial and left ventricular function were decreased,while the systolic became worse.2.STI technique can be used to analyze the changes of the left ventricular function in the early stage.3.PSD can be used as a new parameter to evaluate systolic synchrony.4.STI technique provide a new method for the diagnosis of whether rheumatic immune disease represented by SLE produce cardiac damage. |
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