Speckle tracking echocardiography in acute lupus myocarditis : comparison to conventional echocardiography
Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
BioScientifica
Abstract
Aims: Lupus myocarditis occurs in 5–10% of patients with systemic lupus erythematosus
(SLE). No single feature is diagnostic of lupus myocarditis. Speckle tracking
echocardiography (STE) can detect subclinical left ventricular dysfunction in SLE patients,
with limited research on its utility in clinical lupus myocarditis. We report on STE in
comparison to conventional echocardiography in patients with clinical lupus myocarditis.
Methods and results: A retrospective study was done at a tertiary referral hospital in
South Africa. SLE patients with lupus myocarditis were included and compared to healthy
controls. Echocardiographic images were reanalyzed, including global longitudinal strain
through STE. A poor echocardiographic outcome was defined as final left ventricular
ejection fraction (LVEF) <40%. 28 SLE patients fulfilled the criteria. Global longitudinal
strain correlated with global (LVEF: r = −0.808; P = 0.001) and regional (wall motion score:
r = 0.715; P < 0.001) function. In patients presenting with a LVEF ≥50%, global longitudinal
strain (P = 0.023), wall motion score (P = 0.005) and diastolic function (P = 0.004) were
significantly impaired vs controls. Following treatment, LVEF (35–47% (P = 0.023)) and wall
motion score (1.88–1.5 (P = 0.017)) improved but not global longitudinal strain. Initial LVEF
(34%; P = 0.046) and global longitudinal strain (−9.5%; P = 0.095) were lower in patients
with a final LVEF <40%.
Conclusions: This is the first known report on STE in a series of patients with clinical lupus
myocarditis. Global longitudinal strain correlated with regional and global left ventricular
function. Global longitudinal strain, wall motion score and diastolic parameters may be
more sensitive markers of lupus myocarditis in patients presenting with a preserved LVEF
≥50%. A poor initial LVEF and global longitudinal strain were associated with a persistent
LVEF <40%. Echocardiography is a non-invasive tool with diagnostic and prognostic value
in lupus myocarditis.
Description
CITATION: Du Toit, R., et al. 2017. Speckle tracking echocardiography in acute lupus myocarditis : comparison to conventional echocardiography. Echo Research and Practice, 4(2):9-19, doi:10.1530/ERP-17-0005.
The original publication is available at http://www.echorespract.com
The original publication is available at http://www.echorespract.com
Keywords
Myocarditis, Systemic lupus erythematosus, Echocardiography
Citation
Du Toit, R., et al. 2017. Speckle tracking echocardiography in acute lupus myocarditis : comparison to conventional echocardiography. Echo Research and Practice, 4(2):9-19, doi:10.1530/ERP-17-0005