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Updated: May 10, 2025
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Three-dimensional speckle-tracking imaging for the prognosis of childhood-onset systemic lupus erythematosus: a pilot
Xiaoyuan Feng1, Ping Zhou2, Yan Ding3
1Department of Echocardiography, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
Insights
Childhood-onset systemic lupus erythematosus (cSLE) patients show early left ventricle changes detectable by 3D-STI. The 3D myocardial comprehensive index (3D-MCI) effectively predicts severe disease activity and outcomes in cSLE.
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Childhood-onset systemic lupus erythematosus (cSLE) can affect cardiac function.
- Early detection of cardiac alterations is crucial for managing cSLE patients.
Purpose of the Study:
- To evaluate early left ventricular (LV) architectural and functional changes in cSLE patients using 3D speckle tracking imaging (3D-STI).
- To develop and validate a comprehensive index for predicting disease severity and outcomes in cSLE.
Main Methods:
- 31 cSLE patients were divided into mild-to-moderate (SLEDAI ≤12) and severe (SLEDAI >12) groups.
- 3D-STI parameters, including global longitudinal strain (GLS) and LV twist angle (LVtw), were analyzed.
- A 3D myocardial comprehensive index (3D-MCI) was developed by integrating GLS and LVtw.
Main Results:
- GLS and LVtw were significant indicators of severe disease activity in multivariate analysis.
- The 3D-MCI demonstrated high sensitivity (81.4%) and specificity (94.1%) for severe disease.
- 3D-MCI showed a strong correlation with primary and secondary outcomes.
Conclusions:
- 3D-STI is a valuable tool for early cardiac injury detection in cSLE.
- The 3D-MCI serves as a reliable prognostic indicator for cSLE patients.
Background:
To assess the early alterations in the architecture and performance of the left ventricle for childhood-onset systemic lupus erythematosus (cSLE) patients utilizing three-dimensional speckle tracking imaging (3D-STI).
Methods:
The aggregate of 31 cSLE patients were recruited and categorized into two groups based on the SLE disease activity index (SLEDAI) score: the mild-to-moderate group (≤12, n = 14) and the severe group (>12, n = 17). Univariate as well as multivariate logistic regression were used to investigate the relationship between 3D-STI parameters and the activity of the disease. Four diagnostic patterns were employed to amalgamate 3D-STI data (global longitudinal strain, GLS, and left ventricular twist angle, LVtw): isolation, series, parallel, and integration, subsequently leading to the development of a 3D myocardial comprehensive index (3D-MCI). The primary aim was severe disease activity, whereas the secondary objectives were growth failure, lupus nephritis, hypocomplementemia, and serious hematological issues.
Results:
In the multivariate analysis, GLS and LVtw emerged as significant indicators of severe disease activity (p = 0.028 and p = 0.047). The comprehensive method, which integrates GLS with LVtw value using the logistic algorithm, achieves a balanced sensitivity and specificity of 81.4% and 94.1%, respectively. Subsequently, the 3D-MCI is computed as follows: 7.650-0.367*GLS (%) - 0.281*LVtw (°). Furthermore, the 3D-MCI exhibited a strong significant correlation with both the primary endpoint and the secondary outcomes.
Conclusions:
3D-STI technology may facilitate the early detection of cardiac injury in individuals with cSLE, whereas 3D-MCI serves as suitable prognostic indicators for cSLE patients.
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