Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Systemic sclerosis (SSc) is an autoimmune disease characterized by microvascular damage and excessive fibrosis in the skin and internal organs. Myocardial fibrosis which contributes to either right or left ventricular diastolic dysfunction by reducing the ventricular compliance, is associated with poor prognosis. The aim of this study was to evaluate left ventricular (LV) dysfunction in patients with subclinical cardiac involvement by 2-dimensional speckle tracking echocardiography (2D STE)
Methods: Forty-seven patients (52±12 years, 89.4% women) and 36 gender and age-matched healthy subjects underwent transthoracic 2D STE. We evaluated global LV and RV strains, diastolic variables, cardiac biomarkers, inflammatory and metabolic parameters.
Results: The longitudinal peak systolic strains (PSS)—2CH, longitudinal PSS—APLAX , longitudinal PSS—4CH and global longitudinal PSS of the left ventricle were significantly lower in the SSc group compared with controls (-18,2±3,2% vs. -20± 2,7% p=0.02; -17,8±3,5 vs. -20,3±3,3% p=0,001; -23±3 vs.-21,8±3% p=0,000; -17,5±5,7% vs. -20,6±2,7 % p=0,000 respectively). Although early (E) and late (A) diastolic peak velocity were decreased in SSc group, E/A ratio was similar in both groups. No differences in right ventricle (RV) strain and tricuspid annular plane systolic excursion (TAPSE) were found. B-type natriuretic peptide (BNP), CRP and ESR were significantly higher in patients with SSc (198±250 mg/dl vs.122,5±161 mg/dl p=0,01; 0,5±0,4mg/dl vs. 0,3±0,3 mg/dl p=0,012; 21,7±15 mm/h vs. 11±8,5 mm/h p=0,000 respectively). Although there was no difference between the weights, patients with SSc were shorter than healthy subjects and BMI was significantly higher (28,5±5 vs 25,9±2 kg/m²). The homeostatic model assessment (HOMA) and fasting insulin were also higher in SSc group 1,9±1,3 vs 1,3±0,6 p=0,02; 8±4,9 vs 5,6 ±2,4 IU/mL p=0,008) (Table).
Conclusion: The use of 2D STE can be a sensitive method for detecting subclinic LV dysfunction in SSc patients with preserved left ventricular ejection fraction (LVEF) and pulmonary arterial pressure (PAP). Metabolic and inflammatory parameters should be considered as risk factors for development of overt cardiac disease.
|
SSc |
Healthy Control |
p |
|
| Age (years) | 51,9±12,4 | 49,4±6 |
0,292 |
| Female [n (%)] | 42/47 (89,4%) | 33/36 (91,7%) |
0,724 |
| BMI (kg/m²) | 28,5±5,3 | 25,9±2,2 |
0,011 |
| Current smoking [n (%)] | 11/47 (23,4%) | 12/36 (33,3%) |
o,317 |
| Leukocyte (/µL) | 7602±1844 | 6380±1245 |
0,001 |
| Hemoglobin (g/dl) | 12,8±1,7 | 12,8±1,2 |
0,963 |
| Neutrophil (/µL) | 4634±1584 | 3453±808 |
0,00 |
| Lymphocyte ( /µL) | 2144±823 | 2256±587 |
0,181 |
| CRP (mg/dl) | 0,5±0,4 | 0,3±0,3 |
0,012 |
| ESR (mm/h) | 21,7±14,9 | 11±8,6 |
0,00 |
| Fasting plasma glucose (mg/dl) | 93,5±18 | 92,5±9 |
0,368 |
| Insulin (IU/ml) | 8,06±4,9 | 5,6±2,4 |
0,008 |
| HbA1C (%) | 5,1±1,6 | 5,7±3,4 |
0,225 |
| HOMA | 1,9±1,3 | 1,3±0,6 |
0,015 |
| LDL (mg/dl) | 120±36,8 | 154,7±63,3 |
0,015 |
| Total cholesterol (mg/dl) | 196,5±45 | 230,4±33,6 |
0,007 |
| HDL (mg/dl) | 52,4±15 | 52,7±13 |
0,936 |
| Uric acid (mg/dl) | 4,3±1,3 | 3,9±0,9 |
0,089 |
| E (m/s) | 0,20±0,21 | 0,25±0,27 |
0,049 |
| A (m/s) | 0,18±0,10 | 0,19±0,05 |
0,049 |
| E/A (rate) | 1,33±1,8 | 1,5±2 |
0,794 |
| Longitudinal PSS—APLAX (%) | -18,2±3,2 | -20±2,7 |
0,02 |
| Longitudinal PSS—4CH(%) | -17,8±3,5 | -20,3±3,3 |
0,001 |
| Longitudinal PSS—2CH(%) | -23±3 | -21,8±3 |
0,00 |
| Global longitudinal PSS (%) | -17,5±5,7 | -20,6±2,7 |
0,00 |
| RV PSS (%) | -17,5±4,2 | -18,9±3,9 |
0,121 |
| TAPSE | 21±4 | 21,4±4,6 |
0,71 |
| PAP (mmHg) | 14,5±14 | 11,1±13,2 |
0,311 |
| LVEF (%) | 72,3±6 | 75,4±4,3 |
0,01 |
| Homosistein (mmol/L) | 13,6±5,7 | 11,7±2,6 |
0,22 |
| BNP (pg/ml) | 198±250 (111) | 122,5±16 (70) |
0,01 |
| Galectin 3 (pg/ml) | 7,5±3,2 | 8,1±2,4 |
0,096 |
To cite this abstract in AMA style:
Temiz Karadag D, Sahin T, Tekeoglu S, Ozdemir Işik O, Yazici A, Eraldemir FC, Cefle A. Speckle Tracking Echocardiography: A Sensitive Technique for Detecting Early Left Ventricular Dysfunction in Patients with Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/speckle-tracking%e2%80%afechocardiography-a-sensitive-technique-for-detecting-early-left-ventricular-dysfunction-in-patients-with-systemic-sclerosis/. Accessed .« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/speckle-tracking%e2%80%afechocardiography-a-sensitive-technique-for-detecting-early-left-ventricular-dysfunction-in-patients-with-systemic-sclerosis/