Assessment of Fetal Cardiac Morphology and Function in Pregnant Women With Systemic Lupus Erythematosus Using Speckle Tracking Echocardiography.

PURPOSE: Study aimed to assess fetal heart morphology and function in pregnancies with systemic lupus erythematosus (SLE) utilizing speckle tracking echocardiography (STE) and to evaluate indicators for predicting fetal subclinical cardiac damage in this population.

METHODS

The study involved 99 SLE-affected fetuses and 99 gestational age-matched controls. The fetal cardiac morphology and function parameters were calculated using STE (FetalHQ).

RESULTS

The absolute values of left ventricular (LV) global longitudinal strain (GLS), right ventricular (RV) GLS, LV fractional area change (FAC), and RV FAC in the SLE group were lower than those in the control group (p < 0.001). The 24-segment fractional shortening (FS) analysis revealed significantly lower FS in the SLE group than the controls for LV segments 11-12 and RV segments 4-24. The 24-segment sphericity index (SI) analysis indicated significantly lower SI in the SLE group than the controls for LV segments 1-24 and RV segments 1-8. The LV GLS (AUC = 0.859) and RV GLS (AUC = 0.841) could be considered good predictors of subclinical myocardial damage in SLE-affected fetuses.

CONCLUSIONS

STE indicated that fetuses in pregnant women with SLE present cardiac morphology and function that have changed compared to the controls. Further investigations are needed to evaluate STE indices such as the GLS, FAC, and 24-segment FS and SI to predict fetal prognosis in pregnant women with SLE.