Cardiac magnetic resonance feature tracking evaluates left atrial strain in patients with systemic lupus erythematosus and mitral regurgitation

Purpose To explore left atrial (LA) function in patients with systemic lupus erythematosus (SLE) and mitral regurgitation assessed by cardiac magnetic resonance imaging feature tracking (MRI-FT). Method In this study, 64 SLE patients (35.0 ± 12.3 years, 49 females) and 50 age- and gender-matched healthy controls (32.1 ± 11.2 years, 32 females) were analyzed. Patients with SLE were further classified into two subgroups according to mitral regurgitation defined by echocardiography: mitral regurgitation subgroup ( n = 32) and non-mitral regurgitation subgroup ( n = 32). All subjects underwent cardiac magnetic resonance (CMR) examination and SLE patients underwent extra laboratory testing. LA volume and strain parameters were compared among the three groups, and a correlation analysis was further performed between CMR parameters and clinical variables. Results Patients in both mitral regurgitation and non-mitral regurgitation subgroups showed higher LAVmin (29.15 ± 7.5, 26.22 ± 8.23 vs 21.68 ± 7.67, p = .003, .026) and LAVimin (17.44,14.9 vs 12.62, p = .002,.046) than healthy control subjects. Abnormal LA reservoir, conduit and bump strain were also observed in SLE patients (all p < .05), with more severe reservoir ( p = .006, .031) and bump strain ( p = .01, .033) abnormality found in mitral regurgitation subgroup. In the SLE group, LA reservoir, bump and conduit strain were significantly positively correlated with LVEF (B = 0.467, p < .001 vs B = 0.019, p = .01 vs B = 0.168, p = .001 vs B = 0.036, p < .001 vs B = 0.020, p = .024). Conduit strain (εe, SRe) was positively correlated with LAEF (B = 0.229, p = .032 vs B = 0.027, p = .008). Conclusion MRI-FT based LA parameters may be considered a helpful tool to evaluate LA function in SLE patients, and LA strain may indicate severity of the cardiac dysfunction in SLE patients.