关键词:

肺动脉高压, 右心室功能, 三维超声右心室定量, 系统性红斑狼疮

Abstract:

Objective To application value of fully automatic three⁃dimensional ultrasound right ventricu⁃ lar quantitative software（3DAutoRV）technology in the evaluation of right ventricular systolic function in patients with systemic lupus erythematosus（SLE）. Methods The patients diagnosed with SLE in our hospital from October 2020 to June 2022 were selected. 87 patients were divided into several groups，while 29 healthy people were re⁃ cruited as a control group（group D）. Age，sex，heart rate，body mass index（BMI），and blood pressure were re⁃ corded in all the study subjects. Tricuspid annular displacement（TAPSE），tricuspid annular systolic velocity（S′）， right ventricular area change rate（RVFAC），right ventricular end ⁃diastolic transverse diameter（RVED），right ventricular anterior wall thickness（RVAW）were detected by routine ultrasound examination. 3DAutoRV software obtained right ventricular end⁃diastolic volume（RVEDV），right ventricular end⁃systolic volume（RVESV），right ventricular stroke volume（RVSV），and right ventricular ejection fraction（RVEF），right ventricular basal seg⁃ ment transverse diameter（RVD1），right ventricular median transverse diameter（RVD2），right ventricular length diameter（RVD3），right ventricular free wall longitudinal strain RVLS（SEP），and right ventricular septal longitu⁃dinal strain RVLS（SLS）. Results As compared with SLE patients，there were no significant differences in age， systolic blood pressure，diastolic blood pressure and body mass index in the control group（P > 0.05 for all compar⁃ isons），while heart rate was significantly increased in the group with severe pulmonary hypertension as compared with other groups，and the difference was statistically significant（P < 0.05 for all comparisons）. As compared with the control group，SLE patients had a mild reduction in SLS、RVEF、FWLS and ESV increased. In the moderate likelihood group，TAPSE，FAC，SLS，FWLS，RVEF，and S′ were all reduced，but ESV，EDV increased. TAPSE，FAC，SLS，FWLS，RVEF，and S′ were reduced while ESV，EDV increased in the severe possible group. As compared with the mild possible group，TAPSE，FAC，SLS，FWLS，and RVEF decreased whereas ESV，EDV increased in the moderate possible group，while the difference between S′ was not statistically significant. As compared with the moderate possible group，TAPSE，FAC，S′ ，SLS，FWLS，RVSV and RVEF decreased in the severe possible group，but EDV and ESV increased. The best cut⁃off value of FWLS for predicting SLE⁃PAH was -23.32（AUC = 0.90，P < 0.001）. The consistency test and repeatability analysis showed good repeatability in RVEF and FWLS. Conclusions 3D Auto RV software can provide support for evaluating right ventricular systolic function in SLE patients.

Key words:

pulmonary hypertension, right ventricular function, automatic three ? dimensional ultra? sound quantification of right ventricle, systemic lupus erythematosus