Peak strain dispersion within the left ventricle detected by two-dimensional speckle tracking in patients with uncomplicated systemic lupus erythematosus

Background Many studies in adult patients with systemic lupus erythematosus (SLE) have demonstrated that myocardial dysfunction was significantly associated with enhanced disease activity. However, similar studies in paediatric patients with SLE are limited. The aim of this study was to evaluate the role of speckle tracking echocardiography (STE) to detect left ventricular dysfunction in children with active and inactive SLE. Methods This prospective case–control study was carried out on 50 children with SLE. Thirty healthy age- and sex-matched children comprised the control group. The patients were further subdivided into two subgroups: active SLE and inactive SLE. Laboratory investigations undertaken included complete blood count, renal function, C3, C4, ANA, anti-dsDNA and serum N-terminal pro-B type natriuretic peptide. Echocardiographic examinations were performed on all children and included conventional echocardiography, tissue Doppler imaging (TDI) and two- and three-dimensional STE. Results There was no statistically significant difference in N-terminal pro B natriuretic peptide between the studied groups. The myocardial performance index by TDI was statistically significantly higher in SLE patients compared to controls. STE parameters were statistically significantly lower in SLE patients compared to controls. There was no correlation between STE parameters and disease activity. Conclusions STE could be a promising technique in the early detection of subclinical left ventricular dysfunction in children with SLE.

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Proteomic, biomechanical and functional analyses define neutrophil heterogeneity in systemic lupus erythematosus

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-218338 ◽

2020 ◽

pp. annrheumdis-2020-218338

Author(s):

Kathleen R Bashant ◽

Angel M Aponte ◽

Davide Randazzo ◽

Paniz Rezvan Sangsari ◽

Alexander JT Wood ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Cell Surface ◽

Lupus Erythematosus ◽

Light Sheet ◽

Normal Density ◽

Two Dimensional ◽

Biophysical Properties ◽

Systemic Lupus ◽

Light Sheet Microscopy ◽

Functional Analyses

ObjectivesLow-density granulocytes (LDGs) are a distinct subset of proinflammatory and vasculopathic neutrophils expanded in systemic lupus erythematosus (SLE). Neutrophil trafficking and immune function are intimately linked to cellular biophysical properties. This study used proteomic, biomechanical and functional analyses to further define neutrophil heterogeneity in the context of SLE.MethodsProteomic/phosphoproteomic analyses were performed in healthy control (HC) normal density neutrophils (NDNs), SLE NDNs and autologous SLE LDGs. The biophysical properties of these neutrophil subsets were analysed by real-time deformability cytometry and lattice light-sheet microscopy. A two-dimensional endothelial flow system and a three-dimensional microfluidic microvasculature mimetic (MMM) were used to decouple the contributions of cell surface mediators and biophysical properties to neutrophil trafficking, respectively.ResultsProteomic and phosphoproteomic differences were detected between HC and SLE neutrophils and between SLE NDNs and LDGs. Increased abundance of type 1 interferon-regulated proteins and differential phosphorylation of proteins associated with cytoskeletal organisation were identified in SLE LDGs relative to SLE NDNs. The cell surface of SLE LDGs was rougher than in SLE and HC NDNs, suggesting membrane perturbances. While SLE LDGs did not display increased binding to endothelial cells in the two-dimensional assay, they were increasingly retained/trapped in the narrow channels of the lung MMM.ConclusionsModulation of the neutrophil proteome and distinct changes in biophysical properties are observed alongside differences in neutrophil trafficking. SLE LDGs may be increasingly retained in microvasculature networks, which has important pathogenic implications in the context of lupus organ damage and small vessel vasculopathy.

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The left ventricle in systemic lupus erythematosus: Initial observations and a five-year follow-up in a university medical center population

American Heart Journal ◽

10.1016/0002-8703(93)90123-q ◽

1993 ◽

Vol 125 (4) ◽

pp. 1117-1122 ◽

Cited By ~ 19

Author(s):

Timothy M Winslow ◽

Maxim A Ossipov ◽

Gary P Fazio ◽

Elyse Foster ◽

Jay S Simonson ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Left Ventricle ◽

Lupus Erythematosus ◽

Medical Center ◽

Systemic Lupus

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Early onset left ventricular remodeling in juvenile systemic lupus erythematosus; Insight from 3-dimensional speckle tracking echocardiography

Lupus ◽

10.1177/09612033211051302 ◽

2021 ◽

pp. 096120332110513

Author(s):

Hala M Agha ◽

Mahmoud A Othman ◽

Sonia El-Saiedi ◽

Fatma El Zahrae Hassan ◽

Heba Taher ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Speckle Tracking ◽

Ventricular Remodeling ◽

Speckle Tracking Echocardiography ◽

Left Ventricular Remodeling ◽

Left Ventricular ◽

Systemic Lupus ◽

Lv Dysfunction ◽

The Mean

Background Early diagnosis and treatment of myocardial affection in patients with systemic lupus erythematosus (SLE) are crucial. Objectives To evaluate the ventricular systolic function in juvenile-onset systemic lupus erythematosus (j-SLE) patients by 3-D speckle tracking echocardiography (3D-STE) and to determine the predictors of left ventricular (LV) dysfunction if present. Methods Twenty-six SLE patients without heart failure and 21 healthy controls were studied by standard echocardiogram and 3D-STE. Conventional parameters included LV ejection fraction (EF), fractional shortening (FS), and mitral annular plane systolic excursion (MAPSE). Global LV strain (GLS) and global area strain (GAS) were obtained by 3D-STE. Medical records, including diagnosis criteria, duration of disease, and SLE disease activity index (SLEDAI) were evaluated. Results The mean age was similar in patients and controls 11.42 vs 11.48 years p = 0.93. The mean duration of the disease was 1.87 ± 1.02 years and SLEDAI ranged from 0 to 9. By conventional and tissue Doppler imaging echocardiography, only MAPSE was significantly lower in SLE patients compared to controls (14.56 vs 18.46 mm, p < 0.001). By 3D speckle tracking echocardiography, GLS and GAS were significantly reduced in SLE patients compared to controls (−15.07 vs −19.9.4%, −34.6% vs −39.7%, respectively, p < 0.001). Multiple linear regression and ROC analyses indicated that the SLEDAI score was the only predictive factor for the left ventricular remodeling. Conclusions These results indicate that early subclinical LV dysfunction occur in jSLE patients even with normal EF and SLE disease activity might be a potential driver for LV deformation.

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