Analysis of Diastolic Left Ventricular Function in Adolescents with Juvenile Systemic Lupus Erythematosus

Abstract Background Juvenile systemic lupus erythematosus (JSLE) is a chronic inflammatory disease that affects the heart in 50% of cases. The behavior of diastolic function in adolescents and the predictors of its occurrence by conventional echocardiography are poorly established. Objectives This study aimed to evaluate diastolic function in adolescents with JSLE and to identify possible predictors of its occurrence by conventional echocardiography. Methods Cross-sectional, observational, control group study in a tertiary hospital of 49 adolescents with JSLE and 49 controls, using the EACVI 2016 guideline classification. Statistical methods used were Fisher and Mann-Whitney tests. Multivariate logistic regression models were constructed. A significance level of 5% was adopted. Results Among 98 patients, the JSLE group had higher indexed left atrial volume (p <0.001), lower lateral E' value (p<0.001) and lower E/A ratio value (p<0.001). The diagnosis of JSLE was associated with a higher chance of increased left atrial index volume (OR 3.3; p value 0.03). Conclusions Based on the 2016 guideline, no diastolic dysfunction was found in JSLE. However, differences in the analyzed echocardiographic parameters were found in these adolescents.

摘要
背景：青少年系统性红斑狼疮（Juvenile systemic lupus erythematosus, JSLE）是一种慢性炎症性疾病，约50%的病例会累及心脏。目前针对青少年群体的心脏舒张功能表现，以及常规超声心动图下其异常发生的预测因素，相关研究尚不充分。
研究目的：本研究旨在评估青少年JSLE患者的心脏舒张功能，并通过常规超声心动图明确其异常发生的潜在预测因素。
研究方法：本研究为一项横断面观察性对照研究，于某三级医院开展，共纳入49例JSLE青少年患者与49例健康对照，采用欧洲心血管影像学会（European Association of Cardiovascular Imaging, EACVI）2016年指南的分类标准。统计分析采用Fisher确切概率法与曼-惠特尼U检验，并构建多因素logistic回归模型，检验水准设定为5%。
研究结果：98例受试者中，JSLE组的左心房容积指数更高（p<0.001）、侧壁E'值更低（p<0.001）且E/A比值更低（p<0.001）。JSLE诊断与左心房容积指数升高的风险升高显著相关（优势比[OR] 3.3；p=0.03）。
研究结论：基于2016年指南标准，未在青少年JSLE患者中检出舒张功能障碍，但该群体的超声心动图分析参数存在显著差异。