ORIGINAL ARTICLE Evaluation of cardiac functions in juvenile systemic lupus erythematosus with two-dimensional speckle tracking echocardiography Reyhan Dedeoglu 1 & Sezgin Şahin 2 & Aida Koka 1 & Funda Öztunç 1 & Amra Adroviç 2 & Kenan Barut 2 & Dicle Cengiz 3 & Özgür Kasapçopur 2 Received: 25 February 2016 /Revised: 19 April 2016 /Accepted: 20 April 2016 # International League of Associations for Rheumatology (ILAR) 2016 Abstract The aim of this study was to investigate subclinical systolic and diastolic dysfunction in juvenile-onset systemic lupus erythematosus (j-SLE) patients with speckle tracking echocardiography (STE) and the effects of disease activity on left ventricular (LV) regional functions. Thirty-five patients with j-SLE and 30 healthy children (control group) were eval- uated between January and August 2015. STE was performed on all patients and controls. Medical records, including diag- nosis criteria, age at diagnosis, and duration of disease, were evaluated. SLE disease activity was assessed using the SLE Disease Activity Index (SLEDAI). j-SLE patients had lower ejection fraction than did control subjects but still within nor- mal range. LV end-diastolic and end-systolic dimensions were significantly larger in j-SLE patients (32.43 ± 3.2 vs 28.3 ± 3.1 and 21.1 ± 1.9 vs 18.9.0 ± 2.2, respectively; p = 0.001). There was a significant reduction in longitudinal strain of LV seg- ments in the j-SLE patients compared with controls. J-SLE patients were further divided into subgroups. Group 1 comprised patients having SLEDAI scores >8 at the onset of disease but who improved with therapy during follow-up. Group 2 included j-SLE patients with SLEDAI scores >8 at diagnosis and persistently >4 at the end of follow-up. In the LV mid-inferior and mid-inferolateral segments, STE strain measurements of group 2 were significantly lower than those of group 1 (15.9 ± 6.4 vs 20.0 ± 4.4, 17.9 ± 7.2 vs 23.2 ± 3.8; p = 0.075, p = 0.055, respectively). Simple and non-invasive STE would be helpful in predicting cardiovascular prognosis with new therapeutic medications/interventions or in objec- tively comparing the effects of immunosuppressive drugs in comparison with preceding STE evaluation. Keywords j-SLE . SLEDAI . Speckle tracking echocardiography . Systolic dysfunction . Systolic strain Introduction Systemic lupus erythematosus (SLE) is an autoimmune dis- ease characterised by vasculitis and multiple-organ inflamma- tory processes. Patients with SLE are at risk of complications such as an increased risk of cardiovascular disease [1, 2]. Young females are more prone than young males to cardio- vascular complications [3, 4]. In chronic inflammatory diseases such as SLE, organ involvement may not show clinical signs and detection is difficult. Myocardial involvement in SLE patients is insidious and has no symptoms or warnings. While clin- ical symptoms are non-specific, standard transthoracic echocardiography (TTE) often lacks the sensitivity to detect subclinical ventricular dysfunction [ 5]. Two- dimensional speckle tracking echocardiography (STE) is a more recent method for detecting ventricular dys- function by echocardiographic assessment of myocardial deformation (strain). Strain is basically deformation, or relative change of muscle from its original length, expressed as a percentage of change. The mainstay of deformation imaging is the analysis of segmental move- ments. This analysis provides information about regional * Reyhan Dedeoglu reyhandedeoglu@gmail.com 1 Pediatric Cardiology, Cerrahpasa Medical Faculty, Department of Pediatric Cardiology, Istanbul University, Istanbul, Turkey 2 Pediatric Rheumatology, Cerrahpasa Medical Faculty, Department of Pediatric Cardiology, Istanbul University, Istanbul, Turkey 3 Department of Statistics, Istanbul Commerce University, Istanbul, Turkey Clin Rheumatol DOI 10.1007/s10067-016-3289-7