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Updated: Apr 19, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Evaluation of left atrial function by real-time 3-D echocardiography in patients with systemic lupus erythematosus
Kulin Li1, Ruxing Wang1, Min Dai1
1From the Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou; and the Department of Cardiology, Department of Rheumatology, Wuxi People's Hospital affiliated to Nanjing Medical University, Wuxi, China.K. Li, MD; X. Yang, MD, Professor, Department of Cardiology, First Affiliated Hospital of Soochow University; R. Wang, MD, Professor; M. Dai, MD; J. Lu, MD, Department of Cardiology; Y. Zou, MD, Professor, Department of Rheumatology, Wuxi People's Hospital affiliated to Nanjing Medical University.
Insights
Systemic lupus erythematosus (SLE) impairs left atrial function, particularly in patients with higher disease activity. Real-time 3-D echocardiography (RT3DE) can detect this subclinical cardiac dysfunction.
Area of Science:
- Cardiology
- Rheumatology
- Echocardiography
Background:
- Left atrial function is crucial for cardiac output.
- Left ventricular diastolic dysfunction is known in SLE, but left atrial function impact is understudied.
- Real-time 3-D echocardiography (RT3DE) offers advanced assessment of cardiac structures.
Purpose of the Study:
- To evaluate left atrial performance in patients with SLE using RT3DE.
- To correlate left atrial function with disease severity, assessed by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI).
Main Methods:
- 102 SLE patients and 32 healthy controls were studied.
- Subjects were categorized into healthy controls, SLE with SDI=0, and SLE with SDI≥1.
- Left atrial function was assessed using RT3DE, analyzing volume and emptying fractions.
Main Results:
- SLE patients exhibited dilated left atrial volume and reduced passive emptying fraction.
- Left atrial active emptying fraction was higher in SLE patients with SDI=0 compared to controls.
- Left atrial active emptying fraction was lower in SLE patients with SDI≥1 compared to those with SDI=0.
- SDI was independently associated with increased left atrial volume and decreased total left atrial function.
Conclusions:
- Left atrial mechanical function and volume are impaired in SLE patients, especially those with SDI≥1 and active disease.
- RT3DE shows potential for superior detection of subclinical cardiac dysfunction in SLE compared to traditional echocardiography.
Objective:
Left atrial function plays a key role in maintaining an optimal cardiac output. Left ventricular diastolic dysfunction has been reported in systemic lupus erythematosus (SLE), but its effect on left atrial function has been largely overlooked. Our aim was to assess left atrial performance using real-time 3-D echocardiography (RT3DE) technology in patients with SLE.
Methods:
Our study included 102 patients with SLE without any cardiac symptoms, and 32 healthy controls. According to the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), all subjects were classified into 3 groups: healthy controls, patients with an SDI = 0, and patients with an SDI ≥ 1.
Results:
Left atrial volume indexed to body surface area was dilated in subjects with SLE, whereas the left atrial passive emptying fraction (EF) was lower. Left atrial active EF was significantly higher in the SDI = 0 group than in controls (46.4 ± 9.1% vs 30.0 ± 10.3%, p < 0.05); however, it was significantly lower in the SDI ≥ 1 group than in the SDI = 0 group (41.2 ± 9.8% vs 46.4 ± 9.1%, p < 0.05). By multivariate linear analysis, the SDI was independently and positively associated with left atrial volume index and inversely associated with left atrial total function.
Conclusion:
Our study demonstrated that left atrial mechanical function and volume are impaired in SLE, particularly in patients with an SDI ≥ 1 and disease activity. RT3DE may have better diagnostic value than traditional echo indexes in detecting subclinical cardiac dysfunction in patients with SLE.
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