Speckle tracking echocardiography in acute lupus myocarditis : comparison to conventional echocardiography

dc.contributor.authorDu Toit, Rietteen_ZA
dc.contributor.authorHerbst, Phillip G.en_ZA
dc.contributor.authorVan Rensburg, Annarien_ZA
dc.contributor.authorSnyman, Hendrik W.en_ZA
dc.contributor.authorReuter, Helmuthen_ZA
dc.contributor.authorDoubell, Anton F.en_ZA
dc.date.accessioned2018-08-17T12:25:18Z
dc.date.available2018-08-17T12:25:18Z
dc.date.issued2017
dc.descriptionCITATION: 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.
dc.descriptionThe original publication is available at http://www.echorespract.com
dc.description.abstractAims: 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.en_ZA
dc.description.urihttp://www.echorespract.com/content/4/2/9.full?sid=c26dad46-d821-4592-8805-ad0bba805a46
dc.description.versionPublisher's version
dc.format.extent11 pages
dc.identifier.citationDu 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
dc.identifier.issn2055-0464 (online)
dc.identifier.otherdoi:10.1530/ERP-17-0005
dc.identifier.urihttp://hdl.handle.net/10019.1/104288
dc.language.isoen_ZAen_ZA
dc.publisherBioScientifica
dc.rights.holderAuthors retain copyright
dc.subjectMyocarditisen_ZA
dc.subjectSystemic lupus erythematosusen_ZA
dc.subjectEchocardiographyen_ZA
dc.titleSpeckle tracking echocardiography in acute lupus myocarditis : comparison to conventional echocardiographyen_ZA
dc.typeArticleen_ZA
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