Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose : Myocardial involvement is associated with poor prognosis in patients with systemic sclerosis (SSc). In the present study we aimed to evaluate subclinical left ventricular (LV) and right ventricular (RV) systolic dysfunction in SSc patients without any cardiovascular disease, by using a strain imaging method, “speckle tracking echocardiography” (STE).
Methods : Thirty-six SSc patients were screened, 7 patients were excluded because of ischemic heart disease. We studied 29 patients with SSc (diffuse/ limited: 15/14) and 20 age and sex-matched healthy controls(HC), without any cardiac disease and with preserved LV-EF. Conventional echocardiography and STE-based strain imaging were performed to assess biventricular deformation analyse. Association with anti-Scl 70 was sought in patients with SSc.
Results: In SSc patients (Female/Male: 25/4) the mean age was 47.7 years. Anti Scl-70 was positive in 13 (44.8%) patients. Left ventricular conventional echocardiographic measurements (LV end diastolic diameter, LV end systolic diameter and LV EF) were similar between SSc and HC. Regarding RV conventional parameters, right atrium was significantly enlarged, tricuspidal annular plane systolic excursion (TAPSE) was decreased and systolic pulmonary artery pressure was increased in SSc compared to HC (p<0.001). Both LV and RV longitudinal peak systolic strain/ strain rate were significantly impaired in SSc, demonstrating subclinical LV and RV systolic dysfunction (p≤0.001) (table).
We obtained significant positive correlation between TAPSE and RV longitudinal peak systolic strain/strain rate (r=0.744 and r=0.706, respectively, p=0.0001). Systolic PAB was negatively correlated with both LV and RV longitudinal peak systolic strain/strain rate (LV: r=-0.552 and r= -0.637, respectively, p<0.001 and RV: r=-0.547 and r=-0.638, respectively, p=0.001). Anti Scl -70 positive patients had impaired LV longitudinal peak systolic strain and strain rate values, compared to the others, however the difference did not reach statistical significance (13.01±1.26 % to 13.04±1.90 %, p=0.96 for strain; 0.30±0.06 1/s to 0.31±0.15 1/s, p=0.79 for strain rate).
Conclusion : SSc is associated with myocardial systolic dysfunction. Deformation analysis by STE-based strain imaging is a novel promising modality allowing for detailed measurement of early deterioration in biventricular systolic function in patients with SSc.
Table. Conventional echocardiography and Speckle tracking echocardiography (STE) results of SSc patients and healthy controls.
|
|
SSc
|
HC
|
p value
|
|
Right atrium (cm)
|
3.71±0.30
|
3.43±0.20
|
0.004
|
|
TAPSE (cm)
|
2.01±0.41
|
2.82±0.54
|
0.0001
|
|
Systolic PAB (mmHg)
|
34.13±8.96
|
22.07±3.87
|
0.0001
|
|
LV longitudinal peak systolic strain (%)
|
13.3±1.51
|
18.87±3.78
|
0.0001
|
|
LV strain rate (1/s)
|
0.31±0.11
|
1.77±0.54
|
0.0001
|
|
RV longitudinal peak systolic strain (%)
|
11.83±1.93
|
14.19±2.29
|
0.001
|
|
RV strain rate (1/s)
|
0.30±0.18
|
2.66±0.4
|
0.0001
|
Values were presented as mean ±SD. TAPSE;tricuspidal annular plane systolic excursion, PAB; pulmonary artery pressure, LV; left ventricle, RV; right ventricle
Disclosure:
S. T. Sahin,
None;
S. Yurdakul,
None;
N. Yilmaz,
None;
Y. Cagatay,
None;
S. Aytekin,
None;
S. Yavuz,
None.
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