| Objective:To evaluate the myocardial function in the left ventricle of systemic lupus erythematosus(SLE)patients,and differences between longitudinal and circumferential strain in left ventricular overall,subendocardial myocardium,middle myocardium and subepicardial myocardium were analyzed in SLE patients to explore its value for clinical diagnosis and treatment.Methods:40 total of patients of SLE treated in the Department of Rheumatology of the Second Hospital of Shanxi Medical University were selected,among which SLE patients were divided into group A(less than or equal to 5 years)and group B(more than 5years)according to the course,with 20 patients in each group.The disease activity index was all 0-4.All cases excluded diseases of congenital heart disease,coronary heart disease,heart valvular disease,hypertension,diabetes,arrhythmias,and other systems that could cause heart damage.The 20 patients who were matched by age,sex and SLE patients were selected as group C,which is the control group,and who no previous history of hypertension,diabetes,hyperlipidemia,or other heart disease.General data and biochemical test indicators were collected for all subjects,including sex,age,disease activity index,blood pressure,and other laboratory indicators were included.Routine echocardiographic measures were performed for all subjects.These include left atrial anterior and posterior diameter(LAD),left ventricular end-diastolic and end-systolic internal diameter(LVIDd,LVIDs),ventricular interval and posterior LV wall end-diastolic thickness(IVSd,LVPWd),left ventricular end-diastolic volume and end-systolic volume(End-diastolic volume,End-systolic volume,EDV,ESV),the ratio of peak flow velocity(E/A)between early and late diastole of mitral valve orifice.Left ventricular ejection fraction(LVEF)was measured using the Simpson biplane method.Images of three sections of the left ventricular heart tip and different short axis sections of the left ventricle were collected,with at least three cardiac cycle dynamic images of each section saved,and then the images were stored on the hard disk.Then import it from the hard disk into the Qlab 13.0 offline analysis software for analysis.Images of three sections of the left ventricular apex and different short axes of the left ventricle were retained.The global longitudinal strain(GLS)and global circumferential strains(GCS)of the left ventricle during systole was obtained by recording the endocardium and epicardium.Layer-specific longitudinal and circumferential strains were assessed from endocardial layer,middle layer and epicardial layer by stratified strain technology.If the system is not satisfactory,three layers of myocardium can be manually adjusted to obtain satisfactory tracking results.Last,the results were compared and analyzed.Results:(1)Compared with group A,HDL reduction in Group B(P <0.05).Compared with group C,TC decreased in both groups A and B(P <0.05).(2)Comparison of two-dimensional ultrasound parameters in each group: LAD,A,B and C groups,IVSd,LVIDd,LVPWd,LVIDs,EDV,ESV,LVEF and E / A,were not significantly significant(P>0.05).(3)Comparison of strain parameters:(1)Compared with group C,the GLS and GCS in Group B were significantly reduced(P <0.05),and no statistical difference in GLS and GCS in Group A(P> 0.05);GLS and GCS decreased group B compared with group A(P<0.05).(2)Compared with group C,the LSendo and CSendo in group A was lower than that in group C,but there was no significant difference in the other results in group A(P>0.05).The stratified strain parameters of endocardial layer,middle layer and epicardial layer decreased in group B,and all results in group B also lower compared with group A.(4)Correlation analysis showed that LSendo,LSmid,LSepi,CSendo,CSmid,and CSepi were negatively correlated with the disease course(r=-0.550,r=-0.516,r=-0.493,r=-0.452,r=-0.448,r=-0.423,all were P<0.01).(5)With the course of less than 5 years,LSendo has higher sensitivity and specificity in the diagnosis of SLE myocardial damage than CSendo.Conclusion:The stratified strain technique is able to evaluate the left ventricular myocardial function in patients with SLE and sensitively detect the myocardial damage in different levels,and provide a basis for early clinical diagnosis. |
