| Object: To explore the value of multimodal echocardiography in detecting left ventricular function in patients with systemic lupus erythematosus(SLE).Methods: Thirty SLE patients(SLE group)and 30 normal persons(control group)were selected,and twodimensional echocardiography,tissue Doppler technology and 3D-STI were performed on them,Threechamber and apical long-axis,two-dimensional ultrasound and M-mode ultrasound section,measured left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVEDs),end-ventricular septal end-diastolic thickness(IVSd),end-ventricular end-systolic thickness(IVSs),left ventricular posterior wall end-diastolic thickness(LVPWd),left ventricular posterior wall end-systolic thickness(LVPWs),left ventricular ejection fraction(LVEF),left ventricular shortening fraction(LVFS),stroke volume(SV),Left ventricular end-diastolic volume(EDV),end-systolic volume(ESV),cardiac output(CO),sphericity index(SPI),left-ventricular end-diastolic mass(LV EDmass),left-ventricular end-systolic mass(LV ESmass),and obtain two-dimensional left ventricular ejection fraction(2D-LVEF)with Simpson biplane measurement;using tissue Doppler technology to measured isovolumic relaxation time(IVRT),isovolumetric contraction time(IVCT),ejection time(ET),and applying the formula(IVRT + IVCT)/ ET to calculate the Tei index.3D-STI was used for myocardial motion analysis to obtain the overall left ventricular longitudinal,circumference,radial and area systolic peak strain(GLS,GCS,GRS,GAS),and then,formulas were used to calculate the corresponding first 1/3 point of diastole Strain Imaging Diastolic Index(SI-DI)at the time of formula(SI-DI =(AB)/ A × 100%).Compare the differences of the above parameters between each group,and compared whether 2D-LVEF and 3D-LVEF exist differences,draw different receiver strain characteristics(ROC)for predicting left ventricular myocardial function impairment in SLE patients with different 3D strain parameters,and applyed statistical analysis to analyze the correlation between EF and 3D strain parameters and other indicators differences between groups.Results: The measurement values of echocardiogram(SV,EDV,CO,LV EDmass,LV ESmass)in the SLE group were higher than those in the control group(P<0.05).LVFS in the SLE group were lower than those in the control group(P<0.05);(LVEF,IVSs,LVPWd,LVPWs,ESV,SPI)were not significantly different from the control group(P>0.05);2D-LVEF,3D-LVEF differences were not statistically different between the groups(P>0.05).Compared with the control group,the Tei index of the SLE group was significantly increased(P<0.01).The left ventricle GLS,GCS,GRS,GAS in the SLE group were all lower than those in the control group,and the differences were statistically significant(P<0.05).Calculated by the formula,the left ventricle L-SI-DI,C-SI-DI of the SLE group,R-SI-DI and A-SI-DI were lower than the normal control group,and the differences were statistically significant(P<0.05);the sensitivity of GAS to diagnose SLE was(93.3%),which was higher than GLS(80%),GCS(66.7%),GRS(86.7%).The specificity of GCS in the diagnosis of SLE is(93.3%),which is higher than GLS(86.7%),GAS(86.7%)and GRS(73.3%).The subject's GLS,GCS,GAS,GRS and LVEF all had a linear correlation(r = 0.671,P<0.01;r = 0.678,P<0.01;r = 0.661,P <0.01;r = 0.653,P<0.01).The ROC curve showed that C-SI-DI sensitivity(93.3%)and L-SI-DI sensitivity(86.7%)were higher in SLE patients than in R-SI-DI(80.0%)and A-SI-DI(80.0%);A-SI-DI specificity(93.3%)and R-SI-DI specificity(93.3%)are higher than L-SI-DI(73.3%)and C-SI-DI(73.3%).Conclusion: 1.The combination of three-dimensional speckle tracking technology and tissue Doppler technology helps early detection and quantitative evaluation of left ventricular myocardial systolic and diastolic dysfunction in patients with SLE,early assessment of its subclinical cardiotoxicity,and provides a basis for early clinical intervention.2.The Tei index can effectively assess the changes in the overall heart function. |
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