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. 2026 Feb 6:17:1749478.
doi: 10.3389/fimmu.2026.1749478. eCollection 2026.

Lupus nephritis and its association with subclinical myocardial alterations in systemic lupus erythematosus assessed by cardiovascular magnetic resonance

Zhi Yang #  1 , Ling-Li Wang #  1 , Tian-Yue Zhang  1 , Miao Wen  1 , Hao Zou  2 , Yong Zhu  2 , Xue Meng  1 , Liang-Chao Gao  1 , Bing Fu #  1 , Shu-Yue Pan #  2
Affiliations

Lupus nephritis and its association with subclinical myocardial alterations in systemic lupus erythematosus assessed by cardiovascular magnetic resonance

Zhi Yang et al. Front Immunol. .

Abstract

Background: Lupus nephritis (LN) is the most common and severe complication in patients with systemic lupus erythematosus (SLE) and is associated with cardiac disease. The purpose of this study was to assess the cardiac phenotype of SLE patients with LN using cardiovascular magnetic resonance (CMR), and to investigate whether comorbid LN is associated with left ventricular (LV) remodeling.

Methods: Clinical assessment and CMR were performed in 66 SLE patients without LN, 36 SLE patients with LN, and 20 age- and sex-matched healthy subjects.

Results: SLE patients with LN had a more impaired global longitudinal strain (-12.37 ± 5.15% vs. -14.40 ± 2.80% vs. -14.92 ± 3.04%; P = 0.045) than SLE patients without LN and control group. Moreover, native T1 (1330 ± 54 vs. 1286 ± 81 vs. 1256 ± 41; P<0.001), extracellular volume (ECV) (30.53 ± 4.57% vs. 28.34 ± 3.59% vs. 26.20 ± 3.03; P<0.001), and native T2 (43.69 ± 4.32 vs. 41.98 ± 3.66 vs. 39.60 ± 2.94; P<0.001) were higher in SLE patients with LN, intermediate in SLE patients without LN and lowest in control group. However, LV-LGE did not differ significantly between the SLE patients with or without LN (P > 0.05). In multivariable linear regression, LN status was associated with higher native T1 (β=0.244, P<0.05) and ECV values (β=0.224, P<0.05).

Conclusions: SLE patients with LN showed more pronounced subclinical myocardial abnormalities on CMR. LN was an independent risk factor for cardiac impairment in patients with SLE.

Keywords: T1 mapping; T2 mapping; cardiovascular magnetic resonance imaging; late gadolinium enhancement; strains; systemic lupus erythematosus.

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Conflict of interest statement

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Representative three-dimensional global longitudinal strain in the left ventricle (LV) of systemic lupus erythematosus (SLE) patients with or without lupus nephritis (LN) and control. GRS: global radial strain; GCS: global circumferential strain; GLS: global longitudinal strain.
Figure 2
Figure 2
Distribution of native T1, T2 values and extracellular volume (ECV) of systemic lupus erythematosus (SLE) patients with or without lupus nephritis (LN) and controls. Note that global native T1, ECV, and native T2 were higher in systemic lupus erythematosus (SLE) patients with lupus nephritis (LN), intermediate in SLE patients without LN and lowest in control.
See this image and copyright information in PMC

References

    1. Tzeng HT, Chyuan IT. Immunometabolism in systemic lupus erythematosus: Relevant pathogenetic mechanisms and potential clinical applications. J Formos Med Assoc. (2021) 120:1667–75. doi: 10.1016/j.jfma.2021.03.019, PMID: - DOI - PubMed
    1. Hasan MA, Alali L, Alsadah F, Alobud S, Alsaif J, Alali Z. Prevalence and patterns of renal involvement among patients with systemic lupus erythematous at a tertiary center. J Clin Rheumatol. (2023) 29:84–90. doi: 10.1097/RHU.0000000000001914, PMID: - DOI - PubMed
    1. Lu X, Wang Y, Zhang J, Pu D, Hu N, Luo J, et al. Patients with systemic lupus erythematosus face a high risk of cardiovascular disease: A systematic review and Meta-analysis. Int Immunopharmacol. (2021) 94:107466. doi: 10.1016/j.intimp.2021.107466, PMID: - DOI - PubMed
    1. Symmons DP, Gabriel SE. Epidemiology of CVD in rheumatic disease, with a focus on RA and SLE. Nat Rev Rheumatol. (2011) 7:399–408. doi: 10.1038/nrrheum.2011.75, PMID: - DOI - PubMed
    1. Luo S, Dou WQ, Schoepf UJ, Varga-Szemes A, Pridgen WT, Zhang LJ. Cardiovascular magnetic resonance imaging in myocardial involvement of systemic lupus erythematosus. Trends Cardiovasc Med. (2023) 33:346–54. doi: 10.1016/j.tcm.2022.02.002, PMID: - DOI - PubMed