{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:22:40Z","timestamp":1790878960601,"version":"4.1.0"},"reference-count":57,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003945","name":"Link\u00f6ping University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003945","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Rheumatol Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Although systemic lupus erythematosus (SLE) is associated with an increased risk of cardiovascular disease, conventional echocardiographic measures often fail to detect early myocardial dysfunction. This study assesses left ventricular mechanical dispersion (LVMD) and its associations with vascular pathology in patients with SLE, with the focus on complement proteins. A cross-sectional study was conducted on 55 patients with SLE, categorised into sub-groups with skin and joint involvement, lupus nephritis (LN), and antiphospholipid syndrome (APS), along with 31 age- and sex-matched healthy controls. Speckle tracking echocardiography was used to assess myocardial function, including global longitudinal strain (GLS) and LVMD. The vascular pathology of each subject was evaluated using carotid and central arteries ultrasound to assess the intima-media thickness (IMT) and atherosclerotic plaque burden. LVMD was significantly increased in patients with SLE compared with the controls (p\u2009&lt;\u20090.001), with APS patients displaying the highest values (median, 51\u00a0ms vs. 36\u00a0ms in controls). GLS did not differ between the groups. APS and LN patients exhibited mild right ventricular impairment. Higher LVMD values correlated with increased IMT in the internal carotid artery (p\u2009=\u20090.04) and aortic arch (p\u2009&lt;\u20090.001), as well as with increased atherosclerotic plaque burden (p\u2009=\u20090.04). In multivariable regression analysis, complement protein C4 was an independent predictor of LVMD, suggesting a link between overall systemic inflammation and myocardial dysfunction in SLE. Our findings highlight the importance of speckle tracking echocardiography in uncovering sub-clinical cardiac dysfunction in SLE and call for additional research on complement-directed therapies to prevent atherosclerotic inflammation.<\/jats:p>","DOI":"10.1007\/s00296-025-05939-8","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T11:39:11Z","timestamp":1754480351000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Heterogeneous myocardial contraction detected by speckle tracking echocardiography in systemic lupus erythematosus is associated with complement protein C4: a cross-sectional study from a Swedish tertiary referral centre"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2457-1680","authenticated-orcid":false,"given":"Faria","family":"Shahab","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6536-468X","authenticated-orcid":false,"given":"Helene","family":"Zachrisson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2615-2240","authenticated-orcid":false,"given":"Christina","family":"Svensson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2693-0949","authenticated-orcid":false,"given":"Meriam","family":"\u00c5str\u00f6m Aneq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0900-2048","authenticated-orcid":false,"given":"Christopher","family":"Sj\u00f6wall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2518-1309","authenticated-orcid":false,"given":"David","family":"Kylhammar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"5939_CR1","doi-asserted-by":"publisher","first-page":"2326","DOI":"10.1016\/S0140-6736(24)00398-2","volume":"403","author":"A Hoi","year":"2024","unstructured":"Hoi A, Igel T, Mok CC, Arnaud L (2024) Systemic lupus erythematosus. The Lancet 403:2326\u20132338. https:\/\/doi.org\/10.1016\/S0140-6736(24)00398-2","journal-title":"The Lancet"},{"key":"5939_CR2","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1191\/0961203305lu2200oa","volume":"14","author":"A Doria","year":"2005","unstructured":"Doria A, Iaccarino L, Sarzi-Puttini P et al (2005) Cardiac involvement in systemic lupus erythematosus. Lupus 14:683\u2013686. https:\/\/doi.org\/10.1191\/0961203305lu2200oa","journal-title":"Lupus"},{"key":"5939_CR3","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1093\/rheumatology\/keae120","volume":"64","author":"I Parodis","year":"2025","unstructured":"Parodis I, Haugli-Stephens T, Dominicus A et al (2025) Lupus Low Disease Activity State and organ damage in relation to quality of life in systemic lupus erythematosus: a cohort study with up to 11 years of follow-up. Rheumatology 64:639\u2013647. https:\/\/doi.org\/10.1093\/rheumatology\/keae120","journal-title":"Rheumatology"},{"key":"5939_CR4","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2024-005400","volume":"11","author":"I Parodis","year":"2025","unstructured":"Parodis I, Wincup C, Touma Z et al (2025) Holistic approaches in systemic lupus erythematosus: do physicians avoid addressing difficult-to-treat but highly relevant symptoms? RMD Open 11:e005400. https:\/\/doi.org\/10.1136\/rmdopen-2024-005400","journal-title":"RMD Open"},{"key":"5939_CR5","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.1136\/annrheumdis-2016-210973","volume":"76","author":"EV Arkema","year":"2017","unstructured":"Arkema EV, Svenungsson E, Von Euler M et al (2017) Stroke in systemic lupus erythematosus: a Swedish population-based cohort study. Ann Rheum Dis 76:1544\u20131549. https:\/\/doi.org\/10.1136\/annrheumdis-2016-210973","journal-title":"Ann Rheum Dis"},{"key":"5939_CR6","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2021-000515","volume":"8","author":"I Samuelsson","year":"2021","unstructured":"Samuelsson I, Parodis I, Gunnarsson I et al (2021) Myocardial infarctions, subtypes and coronary atherosclerosis in SLE: a case-control study. Lupus Sci Med 8:e000515. https:\/\/doi.org\/10.1136\/lupus-2021-000515","journal-title":"Lupus Sci Med"},{"key":"5939_CR7","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1002\/acr.23018","volume":"69","author":"JA Avi\u00f1a-Zubieta","year":"2017","unstructured":"Avi\u00f1a-Zubieta JA, To F, Vostretsova K et al (2017) Risk of myocardial infarction and stroke in newly diagnosed systemic lupus erythematosus: a general population-based study. Arthritis Care Res 69:849\u2013856. https:\/\/doi.org\/10.1002\/acr.23018","journal-title":"Arthritis Care Res"},{"key":"5939_CR8","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1177\/0961203311425524","volume":"21","author":"C Bengtsson","year":"2012","unstructured":"Bengtsson C, \u00d6hman M-L, Nived O, Dahlqvist SR (2012) Cardiovascular event in systemic lupus erythematosus in northern Sweden: Incidence and predictors in a 7-year follow-up study. Lupus 21:452\u2013459. https:\/\/doi.org\/10.1177\/0961203311425524","journal-title":"Lupus"},{"key":"5939_CR9","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1093\/oxfordjournals.aje.a009122","volume":"145","author":"S Manzi","year":"1997","unstructured":"Manzi S, Meilahn EN, Rairie JE et al (1997) Age-specific Incidence rates of myocardial infarction and angina in women with systemic lupus erythematosus: comparison with the Framingham Study. Am J Epidemiol 145:408\u2013415. https:\/\/doi.org\/10.1093\/oxfordjournals.aje.a009122","journal-title":"Am J Epidemiol"},{"key":"5939_CR10","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew475","author":"M-L Hermansen","year":"2017","unstructured":"Hermansen M-L, Lindhardsen J, Torp-Pedersen C et al (2017) The risk of cardiovascular morbidity and cardiovascular mortality in systemic lupus erythematosus and lupus nephritis: a Danish nationwide population-based cohort study. Rheumatology. https:\/\/doi.org\/10.1093\/rheumatology\/kew475","journal-title":"Rheumatology"},{"key":"5939_CR11","doi-asserted-by":"publisher","first-page":"25233","DOI":"10.1038\/s41598-024-76462-2","volume":"14","author":"J Xiao","year":"2024","unstructured":"Xiao J, Wu H, Gao Z et al (2024) Association of left ventricular ejection fraction with risk of cardiovascular diseases: a prospective cohort study. Sci Rep 14:25233. https:\/\/doi.org\/10.1038\/s41598-024-76462-2","journal-title":"Sci Rep"},{"key":"5939_CR12","doi-asserted-by":"publisher","first-page":"1849","DOI":"10.1016\/j.jcmg.2019.01.044","volume":"12","author":"J-U Voigt","year":"2019","unstructured":"Voigt J-U, Cvijic M (2019) 2- and 3-dimensional myocardial strain in cardiac health and disease. JACC Cardiovasc Imaging 12:1849\u20131863. https:\/\/doi.org\/10.1016\/j.jcmg.2019.01.044","journal-title":"JACC Cardiovasc Imaging"},{"key":"5939_CR13","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.1093\/eurheartj\/ehv529","volume":"37","author":"OA Smiseth","year":"2016","unstructured":"Smiseth OA, Torp H, Opdahl A et al (2016) Myocardial strain imaging: how useful is it in clinical decision making? Eur Heart J 37:1196\u20131207. https:\/\/doi.org\/10.1093\/eurheartj\/ehv529","journal-title":"Eur Heart J"},{"key":"5939_CR14","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1016\/j.jcmg.2019.03.025","volume":"13","author":"H Kawakami","year":"2020","unstructured":"Kawakami H, Nerlekar N, Haugaa KH et al (2020) Prediction of ventricular arrhythmias with left ventricular mechanical dispersion. JACC Cardiovasc Imaging 13:562\u2013572. https:\/\/doi.org\/10.1016\/j.jcmg.2019.03.025","journal-title":"JACC Cardiovasc Imaging"},{"key":"5939_CR15","doi-asserted-by":"publisher","first-page":"1871","DOI":"10.1007\/s10067-024-06929-0","volume":"43","author":"Y Liu","year":"2024","unstructured":"Liu Y, Yin S, Lin Z et al (2024) Two-dimensional speckle-tracking echocardiography in left ventricular systolic function in patients with systemic lupus erythematosus. Clin Rheumatol 43:1871\u20131880. https:\/\/doi.org\/10.1007\/s10067-024-06929-0","journal-title":"Clin Rheumatol"},{"key":"5939_CR16","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1177\/09612033221106581","volume":"31","author":"JR Azpiri-Lopez","year":"2022","unstructured":"Azpiri-Lopez JR, Galarza-Delgado DA, Garza-Cisneros AN et al (2022) Subclinical systolic dysfunction by speckle tracking echocardiography in patients with systemic lupus erythematosus. Lupus 31:1127\u20131131. https:\/\/doi.org\/10.1177\/09612033221106581","journal-title":"Lupus"},{"key":"5939_CR17","doi-asserted-by":"publisher","first-page":"2947","DOI":"10.21037\/qims-21-805","volume":"12","author":"X Zhong","year":"2022","unstructured":"Zhong X, Chen L, Peng G et al (2022) Early assessment of subclinical myocardial injury in systemic lupus erythematosus by two-dimensional longitudinal layer speckle tracking imaging. Quant Imaging Med Surg 12:2947\u20132960. https:\/\/doi.org\/10.21037\/qims-21-805","journal-title":"Quant Imaging Med Surg"},{"key":"5939_CR18","doi-asserted-by":"publisher","first-page":"140","DOI":"10.4103\/jcecho.jcecho_12_20","volume":"30","author":"S Farag","year":"2020","unstructured":"Farag S, Bastawisy R, Hamouda M et al (2020) Value of speckle tracking echocardiography for early detection of left ventricular dysfunction in patients with systemic lupus erythematosus. J Cardiovasc Echography 30:140. https:\/\/doi.org\/10.4103\/jcecho.jcecho_12_20","journal-title":"J Cardiovasc Echography"},{"key":"5939_CR19","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1016\/j.echo.2020.04.018","volume":"33","author":"T Gegenava","year":"2020","unstructured":"Gegenava T, Gegenava M, Steup-Beekman GM et al (2020) Left ventricular systolic function in patients with systemic lupus erythematosus and its association with cardiovascular events. J Am Soc Echocardiogr 33:1116\u20131122. https:\/\/doi.org\/10.1016\/j.echo.2020.04.018","journal-title":"J Am Soc Echocardiogr"},{"key":"5939_CR20","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12947-022-00295-0","volume":"20","author":"H Zhang","year":"2022","unstructured":"Zhang H, Yang C, Gao F et al (2022) Evaluation of left ventricular systolic function in patients with systemic lupus erythematosus using ultrasonic layer-specific strain technology and its association with cardiovascular events: a long-term follow-up study. Cardiovasc Ultrasound 20:25. https:\/\/doi.org\/10.1186\/s12947-022-00295-0","journal-title":"Cardiovasc Ultrasound"},{"key":"5939_CR21","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1177\/09612033221102713","volume":"31","author":"W He","year":"2022","unstructured":"He W, Xie P, Li W et al (2022) Impaired left ventricular systolic synchrony in patients with lupus Nephritis: a speckle tracking echocardiography study. Lupus 31:1084\u20131093. https:\/\/doi.org\/10.1177\/09612033221102713","journal-title":"Lupus"},{"key":"5939_CR22","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1177\/09612033221089150","volume":"31","author":"X-F Zhong","year":"2022","unstructured":"Zhong X-F, Chen L-X, Liu L-X et al (2022) Early detect left ventricular subclinical myocardial dysfunction in patients with systemic lupus erythematosus by a left ventricular pressure-strain loop. Lupus 31:596\u2013605. https:\/\/doi.org\/10.1177\/09612033221089150","journal-title":"Lupus"},{"key":"5939_CR23","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1002\/acr2.11585","volume":"5","author":"EV Arkema","year":"2023","unstructured":"Arkema EV, Saleh M, Simard JF, Sj\u00f6wall C (2023) Epidemiology and damage accrual of systemic lupus Erythematosus in Central Sweden: a Single-Center Population-Based Cohort Study Over 14 Years From \u00d6sterg\u00f6tland County. ACR Open Rheumatol 5:426\u2013432. https:\/\/doi.org\/10.1002\/acr2.11585","journal-title":"ACR Open Rheumatol"},{"key":"5939_CR24","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1002\/art.1780251101","volume":"25","author":"EM Tan","year":"1982","unstructured":"Tan EM, Cohen AS, Fries JF et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271\u20131277. https:\/\/doi.org\/10.1002\/art.1780251101","journal-title":"Arthritis Rheum"},{"key":"5939_CR25","doi-asserted-by":"publisher","first-page":"2677","DOI":"10.1002\/art.34473","volume":"64","author":"M Petri","year":"2012","unstructured":"Petri M, Orbai A, Alarc\u00f3n GS et al (2012) Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 64:2677\u20132686. https:\/\/doi.org\/10.1002\/art.34473","journal-title":"Arthritis Rheum"},{"key":"5939_CR26","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.3233\/JAD-190327","volume":"70","author":"H Ihle-Hansen","year":"2019","unstructured":"Ihle-Hansen H, Vigen T, Berge T et al (2019) Carotid atherosclerosis and cognitive function in a general population aged 63\u201365 years: data from the Akershus Cardiac Examination (ACE) 1950 study. J Alzheimer\u2019s Dis 70:1041\u20131049. https:\/\/doi.org\/10.3233\/JAD-190327","journal-title":"J Alzheimer\u2019s Dis"},{"key":"5939_CR27","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1111\/j.1538-7836.2006.01753.x","volume":"4","author":"S Miyakis","year":"2006","unstructured":"Miyakis S, Lockshin MD, Atsumi T et al (2006) International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 4:295\u2013306. https:\/\/doi.org\/10.1111\/j.1538-7836.2006.01753.x","journal-title":"J Thromb Haemost"},{"key":"5939_CR28","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1016\/j.berh.2005.03.010","volume":"19","author":"B Griffiths","year":"2005","unstructured":"Griffiths B, Mosca M, Gordon C (2005) Assessment of patients with systemic lupus erythematosus and the use of lupus disease activity indices. Best Pract Res Clin Rheumatol 19:685\u2013708. https:\/\/doi.org\/10.1016\/j.berh.2005.03.010","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"5939_CR29","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1002\/acr.24221","volume":"72","author":"S Arora","year":"2020","unstructured":"Arora S, Isenberg DA, Castrejon I (2020) Measures of adult systemic lupus erythematosus: disease activity and damage. Arthritis Care Res 72:27\u201346. https:\/\/doi.org\/10.1002\/acr.24221","journal-title":"Arthritis Care Res"},{"key":"5939_CR30","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2020.581336","volume":"7","author":"C Svensson","year":"2020","unstructured":"Svensson C, Eriksson P, Zachrisson H, Sj\u00f6wall C (2020) High-frequency ultrasound of multiple arterial areas reveals increased intima media thickness, vessel wall appearance, and atherosclerotic plaques in systemic lupus erythematosus. Front Med 7:581336. https:\/\/doi.org\/10.3389\/fmed.2020.581336","journal-title":"Front Med"},{"key":"5939_CR31","doi-asserted-by":"publisher","first-page":"247","DOI":"10.7326\/0003-4819-145-4-200608150-00004","volume":"145","author":"AS Levey","year":"2006","unstructured":"Levey AS, Coresh J, Greene T et al (2006) Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 145:247\u2013254. https:\/\/doi.org\/10.7326\/0003-4819-145-4-200608150-00004","journal-title":"Ann Intern Med"},{"key":"5939_CR32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2019.102340","volume":"106","author":"H Enocsson","year":"2020","unstructured":"Enocsson H, Wirestam L, Dahle C et al (2020) Soluble urokinase plasminogen activator receptor (suPAR) levels predict damage accrual in patients with recent-onset systemic lupus erythematosus. J Autoimmun 106:102340. https:\/\/doi.org\/10.1016\/j.jaut.2019.102340","journal-title":"J Autoimmun"},{"key":"5939_CR33","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1016\/j.echo.2005.10.005","volume":"18","author":"RM Lang","year":"2005","unstructured":"Lang RM, Bierig M, Devereux RB et al (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography\u2019s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology. J Am Soc Echocardiogr 18:1440\u20131463. https:\/\/doi.org\/10.1016\/j.echo.2005.10.005","journal-title":"J Am Soc Echocardiogr"},{"key":"5939_CR34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","volume":"28","author":"RM Lang","year":"2015","unstructured":"Lang RM, Badano LP, Mor-Avi V et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28:1-39.e14. https:\/\/doi.org\/10.1016\/j.echo.2014.10.003","journal-title":"J Am Soc Echocardiogr"},{"key":"5939_CR35","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.13815","volume":"6","author":"\u00c9 Tam\u00e1s","year":"2018","unstructured":"Tam\u00e1s \u00c9, Nylander E (2018) Decision support for assessment of left ventricular diastolic function. Physiol Rep 6:e13815. https:\/\/doi.org\/10.14814\/phy2.13815","journal-title":"Physiol Rep"},{"key":"5939_CR36","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1093\/ehjci\/jew005","volume":"17","author":"TF Haland","year":"2016","unstructured":"Haland TF, Almaas VM, Hasselberg NE et al (2016) Strain echocardiography is related to fibrosis and ventricular arrhythmias in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 17:613\u2013621. https:\/\/doi.org\/10.1093\/ehjci\/jew005","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"5939_CR37","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.1093\/ehjci\/jeaa187","volume":"21","author":"R Abou","year":"2020","unstructured":"Abou R, Prihadi EA, Goedemans L et al (2020) Left ventricular mechanical dispersion in ischaemic cardiomyopathy: association with myocardial scar burden and prognostic implications. Eur Heart J Cardiovasc Imaging 21:1227\u20131234. https:\/\/doi.org\/10.1093\/ehjci\/jeaa187","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"5939_CR38","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1093\/ehjci\/jeab021","volume":"22","author":"SJ Trivedi","year":"2021","unstructured":"Trivedi SJ, Campbell T, Stefani LD et al (2021) Strain by speckle tracking echocardiography correlates with electroanatomic scar location and burden in ischaemic cardiomyopathy. Eur Heart J Cardiovasc Imaging 22:855\u2013865. https:\/\/doi.org\/10.1093\/ehjci\/jeab021","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"5939_CR39","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jez210","author":"EN Aagaard","year":"2019","unstructured":"Aagaard EN, Kvisvik B, Pervez MO et al (2019) Left ventricular mechanical dispersion in a general population: data from the Akershus Cardiac Examination 1950 study. Eur Heart J Cardiovasc Imaging. https:\/\/doi.org\/10.1093\/ehjci\/jez210","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"5939_CR40","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/s00296-025-05894-4","volume":"45","author":"D Suszek","year":"2025","unstructured":"Suszek D, Pop\u0142awska M, Pro\u015bniak J et al (2025) A novel approach to cardiovascular events in patients with systemic lupus erythematosus: risk factor assessment and treatment analysis. Rheumatol Int 45:139. https:\/\/doi.org\/10.1007\/s00296-025-05894-4","journal-title":"Rheumatol Int"},{"key":"5939_CR41","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.21037\/qims-20-859","volume":"11","author":"T Luo","year":"2021","unstructured":"Luo T, Wang Z, Chen Z et al (2021) Layer-specific strain and dyssynchrony index alteration in new-onset systemic lupus erythematosus patients without cardiac symptoms. Quant Imaging Med Surg 11:1271\u20131283. https:\/\/doi.org\/10.21037\/qims-20-859","journal-title":"Quant Imaging Med Surg"},{"key":"5939_CR42","doi-asserted-by":"publisher","first-page":"2197","DOI":"10.1007\/s10554-021-02201-7","volume":"37","author":"C Li","year":"2021","unstructured":"Li C, Li K, Yuan M et al (2021) Peak strain dispersion within the left ventricle detected by two-dimensional speckle tracking in patients with uncomplicated systemic lupus erythematosus. Int J Cardiovasc Imaging 37:2197\u20132205. https:\/\/doi.org\/10.1007\/s10554-021-02201-7","journal-title":"Int J Cardiovasc Imaging"},{"key":"5939_CR43","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s12872-024-04451-4","volume":"25","author":"X Zhao","year":"2025","unstructured":"Zhao X, Zhang L, Wang L et al (2025) Magnetic resonance imaging quantification of left ventricular mechanical dispersion and scar heterogeneity optimize risk stratification after myocardial infarction. BMC Cardiovasc Disord 25:2. https:\/\/doi.org\/10.1186\/s12872-024-04451-4","journal-title":"BMC Cardiovasc Disord"},{"key":"5939_CR44","doi-asserted-by":"publisher","first-page":"1632","DOI":"10.1111\/echo.15189","volume":"38","author":"J Feng","year":"2021","unstructured":"Feng J, Zhai Z, Wang Z et al (2021) Speckle tracking imaging combined with myocardial comprehensive index to evaluate left ventricular function changes in patients with systemic lupus erythematosus. Echocardiography 38:1632\u20131640. https:\/\/doi.org\/10.1111\/echo.15189","journal-title":"Echocardiography"},{"key":"5939_CR45","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1002\/1529-0131(199901)42:1<51::AID-ANR7>3.0.CO;2-D","volume":"42","author":"S Manzi","year":"1999","unstructured":"Manzi S, Selzer F, Sutton-Tyrrell K et al (1999) Prevalence and risk factors of carotid plaque in women with systemic lupus erythematosus. Arthritis Rheum 42:51\u201360. https:\/\/doi.org\/10.1002\/1529-0131(199901)42:1%3c51::AID-ANR7%3e3.0.CO;2-D","journal-title":"Arthritis Rheum"},{"key":"5939_CR46","doi-asserted-by":"publisher","first-page":"2399","DOI":"10.1056\/NEJMoa035471","volume":"349","author":"MJ Roman","year":"2003","unstructured":"Roman MJ, Shanker B-A, Davis A et al (2003) Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. N Engl J Med 349:2399\u20132406. https:\/\/doi.org\/10.1056\/NEJMoa035471","journal-title":"N Engl J Med"},{"key":"5939_CR47","doi-asserted-by":"publisher","first-page":"3412","DOI":"10.1002\/art.22924","volume":"56","author":"MJ Roman","year":"2007","unstructured":"Roman MJ, Crow MK, Lockshin MD et al (2007) Rate and determinants of progression of atherosclerosis in systemic lupus erythematosus. Arthritis Rheum 56:3412\u20133419. https:\/\/doi.org\/10.1002\/art.22924","journal-title":"Arthritis Rheum"},{"key":"5939_CR48","doi-asserted-by":"publisher","first-page":"2519","DOI":"10.3324\/haematol.2018.209536","volume":"104","author":"M Benagiano","year":"2019","unstructured":"Benagiano M, Borghi MO, Romagnoli J et al (2019) Interleukin-17\/Interleukin-21 and Interferon-\u03b3 producing T cells specific for \u03b22 Glycoprotein I in atherosclerosis inflammation of systemic lupus erythematosus patients with antiphospholipid syndrome. Haematologica 104:2519\u20132527. https:\/\/doi.org\/10.3324\/haematol.2018.209536","journal-title":"Haematologica"},{"key":"5939_CR49","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1007\/s11883-025-01279-x","volume":"27","author":"D Ramoni","year":"2025","unstructured":"Ramoni D, Carbone F, Kraler S et al (2025) Inflammation-driven plaque erosion in atherosclerosis: a focus on complement system pathways. Curr Atheroscler Rep 27:42. https:\/\/doi.org\/10.1007\/s11883-025-01279-x","journal-title":"Curr Atheroscler Rep"},{"key":"5939_CR50","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1097\/01.hjr.0000244582.30421.b2","volume":"14","author":"G Engstr\u00f6m","year":"2007","unstructured":"Engstr\u00f6m G, Hedblad B, Janzon L, Lindg\u00e4rde F (2007) Complement C3 and C4 in plasma and incidence of myocardial infarction and stroke: a population-based cohort study. Eur J Cardiovasc Prev Rehabil 14:392\u2013397. https:\/\/doi.org\/10.1097\/01.hjr.0000244582.30421.b2","journal-title":"Eur J Cardiovasc Prev Rehabil"},{"key":"5939_CR51","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.amjcard.2007.02.075","volume":"100","author":"E Cavusoglu","year":"2007","unstructured":"Cavusoglu E, Eng C, Chopra V et al (2007) Usefulness of the serum complement component C4 as a predictor of stroke in patients with known or suspected coronary artery disease referred for coronary angiography. Am J Cardiol 100:164\u2013168. https:\/\/doi.org\/10.1016\/j.amjcard.2007.02.075","journal-title":"Am J Cardiol"},{"key":"5939_CR52","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1038\/nrrheum.2012.75","volume":"8","author":"G Sturfelt","year":"2012","unstructured":"Sturfelt G, Truedsson L (2012) Complement in the immunopathogenesis of rheumatic disease. Nat Rev Rheumatol 8:458\u2013468. https:\/\/doi.org\/10.1038\/nrrheum.2012.75","journal-title":"Nat Rev Rheumatol"},{"key":"5939_CR53","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2019-000333","volume":"6","author":"E Mulvihill","year":"2019","unstructured":"Mulvihill E, Ardoin S, Thompson SD et al (2019) Elevated serum complement levels and higher gene copy number of complement C4B are associated with hypertension and effective response to statin therapy in childhood-onset systemic lupus erythematosus (SLE). Lupus Sci Med 6:e000333. https:\/\/doi.org\/10.1136\/lupus-2019-000333","journal-title":"Lupus Sci Med"},{"key":"5939_CR54","doi-asserted-by":"publisher","first-page":"32301","DOI":"10.1074\/jbc.M504828200","volume":"280","author":"A Sj\u00f6berg","year":"2005","unstructured":"Sj\u00f6berg A, \u00d6nnerfjord P, M\u00f6rgelin M et al (2005) The Extracellular Matrix and Inflammation. J Biol Chem 280:32301\u201332308. https:\/\/doi.org\/10.1074\/jbc.M504828200","journal-title":"J Biol Chem"},{"key":"5939_CR55","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1038\/s41569-024-01016-y","volume":"21","author":"P Maffia","year":"2024","unstructured":"Maffia P, Mauro C, Case A, Kemper C (2024) Canonical and non-canonical roles of complement in atherosclerosis. Nat Rev Cardiol 21:743\u2013761. https:\/\/doi.org\/10.1038\/s41569-024-01016-y","journal-title":"Nat Rev Cardiol"},{"key":"5939_CR56","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1007\/s00296-020-04694-2","volume":"40","author":"DP Misra","year":"2020","unstructured":"Misra DP, Gasparyan AY, Zimba O (2020) Benefits and adverse effects of hydroxychloroquine, methotrexate and colchicine: searching for repurposable drug candidates. Rheumatol Int 40:1741\u20131751. https:\/\/doi.org\/10.1007\/s00296-020-04694-2","journal-title":"Rheumatol Int"},{"key":"5939_CR57","doi-asserted-by":"crossref","unstructured":"Shahab F, Zachrisson H, Svensson C, et al (2023) AB0577 Left ventricular dyssynchrony in subjects with different SLE phenotypes. Ann Rheum Dis 82:1486. https:\/\/ard.bmj.com\/content\/82\/Suppl_1\/1486.1","DOI":"10.1136\/annrheumdis-2023-eular.2710"}],"container-title":["Rheumatology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-025-05939-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00296-025-05939-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-025-05939-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T06:53:48Z","timestamp":1755759228000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00296-025-05939-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,6]]},"references-count":57,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["5939"],"URL":"https:\/\/doi.org\/10.1007\/s00296-025-05939-8","relation":{},"ISSN":["1437-160X"],"issn-type":[{"value":"1437-160X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,6]]},"assertion":[{"value":"7 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no potential conflicts of interest with respect to the research, authorship, and\/or publication of this article. Since April 2024, CSj is an employee of Bristol Myers Squibb.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Local Ethics Committee in Link\u00f6ping (Decision nos. M75\u201308, 2013\/33\u201331) and the Swedish Ethical Review Authority (2022\u201306339\u201302). All subjects provided written informed consent, and the study adhered to the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Preliminary data from the current work have been previously presented at one scientific meeting [].","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Congress abstract publication"}}],"article-number":"183"}}