Subclinical right ventricle systolic dysfunction in childhood-onset systemic lupus erythematosus: insights from two-dimensional speckle-tracking echocardiography

Autor(es)

Leal, G. N. ^[1] ; Silva, K. F. ^[1] ; Franca, C. M. P. ^[2] ; Lianza, A. C. ^[1] ; Andrade, J. L. ^[3] ; Campos, L. M. A. ^[2] ; Bonfa, E. ^[4] ; Silva, C. A. ^[2]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Med, Inst Crianca, Radiol Unit, Hosp Clin, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med, Inst Crianca, Pediat Rheumatol Unit, Hosp Clin, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med, Dept Radiol, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Dept Rheumatol, Fac Med, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Lupus; v. 24, n. 6, p. 613-620, MAY 2015.
• Citações Web of Science: 16

Resumo

Objective The objective of this article is to evaluate right ventricle strain imaging by two-dimensional speckle-tracking (2DST) in childhood-onset systemic lupus erythematosus (c-SLE). Methods Thirty-five c-SLE patients with no signs or symptoms of heart failure and 33 healthy volunteers were evaluated by standard echocardiogram and 2DST. Conventional parameters included tricuspid annular plane systolic excursion (TAPSE), RV tissue-Doppler-derived Tei index and systolic pulmonary artery pressure. Global peak longitudinal systolic strain (PLSS) and strain rate (PLSSR) of RV were obtained by 2DST. Demographic/clinical features, SLEDAI-2K/SLICC/ACR-DI and treatment were also assessed. Results The median current age was similar in patients and controls (14.75 vs. 14.88 years, p=0.62). RV PLSS was significantly reduced in c-SLE (-24.55.09 vs. -27.62 +/- 3.02%, p=0.003). Similar findings were observed after excluding patients with pulmonary hypertension (-24.62 +/- 4.87% vs. -27.62 +/- 3.02%, p=0.0041). RV PLSS was positively correlated with TAPSE (r=+0.49, p=0.0027) and negatively correlated with Tei index (r=-0.34, p=0.04) in c-SLE. RV PLSSR was not different comparing patients and controls (-0.65s(-1)+/- 0.47 vs. -1.87 +/- 0.49s(-1), p=0.07). Further analysis of c-SLE patients revealed higher frequencies of neuropsychiatric manifestations (39% vs. 0%, p=0.007) and antiphospholipid antibodies (55% vs. 18%, p=0.035) in those with RV PLSS-23.7% vs >-23.7%. No differences were evidenced in demographic data, disease activity/damage or treatments (p>0.05). Conclusions The present study, using a new and more sensitive technique, revealed subclinical RV systolic dysfunction in c-SLE patients that may have future prognostic implications. The novel association of asymptomatic RV dysfunction with neuropsychiatric manifestations and antiphospholipid antibodies may suggest common physiopathological pathways. (AU)

• Processo FAPESP: 11/12471-2 - Avaliação da reserva ovariana, do anticorpo anti-corpo lúteo e da infecção do trato genital inferior de mulheres adultas com lúpus eritematoso sistêmico, síndrome de Behçet e arterite de Takayasu
• Beneficiário: Clovis Artur Almeida da Silva
• Modalidade de apoio: Auxílio à Pesquisa - Regular