Objective:The aim of this study was to investigate the early left atrial (LA) performance in patients with systemic lupus erythematosus (SLE) by two dimensional speckle tracking imaging (STI) combined with real time three dimensional echocardiography (RT3DE). Methods: A total of 40 SLE patients and 38 healthy controls were enrolled. The mean strain rates during systole, early diastole and late diastole (mSRs, mSRe, and mSRa) were measured at each segment (anterior, posterior, lateral, and septal) by STI. LA active ejection fraction (LAAEF), LA passive ejection fraction (LAPEF) and atrial expansion index (AEI) were calculated by RT3DE. The correlations between the above LA functional parameters and strain rates were analyzed. Results: ①Early diastolic mitral annular velocity in the SLE group and the control group was(0.67 ± 0.12)m/s and (0.72 ± 0.11) m/s, respectively (P > 0.05). ②The mSRs in the SLE group and the control was (3.81 ± 1.02)/s and (4.09 ± 1.13)/s, respectively (P > 0.05); The mSRe was (-3.68 ± 1.70)/s and (-4.11 ± 0.79)/s, respectively (P < 0.05); and the mSRa was (-3.73 ± 1.56)/s and (-2.89 ± 0.79)/s, respectively (P < 0.01). ③LAAEF in the SLE group and the control group was (48.0 ± 8.9)% and (33.0 ± 7.4)%, respectively (P < 0.01); LAPEF was (37.1 ± 8.2)% and (49.5 ± 7.4)%, respectively (P < 0.01); and AEI was (85.7 ± 27.5)% and (95.3 ± 22.5)%, respectively (P=0.17). ④There were significant positive correlations among AEI and SRs (r=0.756, P < 0.01), LAAEF and SRa (r=0.816, P < 0.01), LAPEF and SRe (r=0.786, P < 0.01). Conclusion: LA functions are changed in early stage of SLE patients, demonstrating the impairment in conduit function, the decrease in storage function and the increase in pump function.