Echocardiographic evaluation of right ventricle-pulmonary artery coupling in systemic lupus erythematosus patients combined with pulmonary hypertension
Objective To observe changes of cardiac function in systemic lupus erythematosus(SLE)patients with different pulmonary artery pressure,and to explore correlations of right ventricle pulmonary artery(RV-PA)coupling parameters with right ventricular function and mean pulmonary artery pressure(mPAP).Methods Data of 69 SLE patients were retrospectively analyzed.According to tricuspid regurgitation velocity(TRV)and the presence or absence of pulmonary arterial hypertension(PAH),patients without PAH were categorized into group A(TRV≤2.8 m/s)or B(TRV＞2.8 m/s),while those with PAH into group C(mPAP≥25 mmHg).Two-dimensional transthoracic echocardiography and real-time three-dimensional echocardiography results were reviewed to comparatively observe right heart size and right ventricular volume,left and right ventricular systolic and diastolic function,as well as tricuspid annular systolic displacement/pulmonary artery systolic pressure(TAPSE/PASP)among groups,and correlations of TAPSE/PASP with changes of right ventricular function and mPAP were analyzed.Results Compared with group A,the right heart enlarged in group C,and the right ventricular volume increased in groups B and C(all adjusted P＜0.05).Right ventricular systolic function progressively reduced in groups A,B and C,while right ventricular diastolic function reduced in groups B and C compared with group A(all adjusted P＜0.05),but no significant difference of left ventricular systolic nor diastolic function was found among 3 groups(all P＞0.05).TAPSE/PASP was negatively correlated with right ventricular end diastolic volume(rs=-0.420,P＜0.001)and positively correlated with right ventricular ejection fraction(rs=0.584,P＜0.001).TAPSE/PASP was negatively correlated with mPAP in group C(rs=-0.539,P=0.012).Conclusion SLE complicated with elevated pulmonary artery systolic pressure might have reduced right ventricular function,in whom TAPSE/PASP correlated with right ventricular systolic and diastolic function as well as mPAP.
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