Assessment of left ventricular function in systemic lupus erythematosus patients by speckle tracking echocardiography: Relation to circulating endothelial progenitor cells

Citation:
SWG, B., E. M, A. AR, and H. MS, "Assessment of left ventricular function in systemic lupus erythematosus patients by speckle tracking echocardiography: Relation to circulating endothelial progenitor cells", The Egyptian Rheumatologist, vol. 37, pp. S33-S41, 2015.

Abstract:

Background Systemic lupus erythematosus (SLE) is an autoimmune disease associated with reduced number and impaired function of endothelial progenitor cells (EPCs) responsible for vascular regeneration. Aim The aim of this study was to assess left ventricular (LV) function of SLE patients using the relatively new speckle tracking echocardiography (STE) and examine whether any detected abnormalities of LV function have any relation with peripheral circulating EPCs level. Methods Fifty SLE patients and 25 healthy controls were subjected to quantification of peripheral circulating VEGFR2+/CD133+ and VEGFR2+/CD34+ EPCs, transthoracic echocardiography (TTE), tissue Doppler imaging (TDI) and STE. Results Patients showed a significantly lower CD133+/VEGFR2+ EPCs (p= 0.009) and CD34+/VEGFR2+ EPCs counts (p= 0.0001) compared to controls. TTE/TDI revealed a significantly lower LV ejection fraction (EF) (p=0.007), higher LV end systolic dimensions (p=0.02), myocardial performance index (MPI) (p=0.0001) and mitral flow E/lateral annulus E' ratio (p=0.002) in patients compared to controls. STE showed a significantly lower global longitudinal strain (GLS) (p value <0.001), global circumferential strain (GCS) (p<0.001) and global strain rate during isovolumic relaxation period (GSRivr) (p=0.01) in patients compared to controls. No correlation was detected between age of the patients, duration of disease, prednisolone dose or intake duration, use of azathioprine vs. cyclophosphamide, SLE disease activity index, LV MPI, LV EF, CD133+/VEGFR2+ EPCs or CD34+/VEGFR2+ EPCs count and GLS. By multiple logistic regression analysis, the independent variables affecting GCS and GSRivr were the prednisolone dose and the LVEF respectively. (95% CI = -0.46 to -0.03; p= 0.03 and 95% CI = 0.001 to 0.01; p=0.021; respectively). Conclusion
STE detected subclinical systolic and diastolic abnormalities of LV function in SLE patients. These abnormalities of LV function did not show however any relation with the significantly lower EPCs count detected in patients.