Session Information
Date: Monday, November 9, 2015
Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's - Clinical Aspects and Therapeutics Poster II
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose:
Abstract Number: 1890
Subclinical Biventricular Systolic Function Is Impaired in Patients with Systemic Sclerosis with Real Time 3-D Echpcardiography: 1 Year Follow-up Study
Silent myocardial involvement is associated with poor prognosis in patients with systemic sclerosis (SSc). Here, we aimed to evaluate subclinical left ventricular (LV) and right ventricular (RV) systolic dysfunction in SSc patients without any cardiovascular disease, by using both strain imaging method, “speckle tracking” (STE) and real time 3-D Echocardiography.
Methods:
Fifty-five SSc patients were screened, 7 patients were excluded because of ischemic heart disease. 25 age and sex-matched healthy controls (HC), without any cardiac disease and with preserved LV-EF were studied as controls. Conventional echocardiography, STE-based strain imaging and real time 3-D echocardiography (Bothell, WA,USA) were performed to assess biventricular deformation analyse. Association with anti-Scl 70 was sought in patients with SSc.
Results:
In SSc patients (Female/Male: 44/4) the mean age was 47.7 years. Anti Scl-70 seropositivity was 22 (45.8%). Left ventricular conventional echocardiographic measurements (LV end diastolic diameter, LV end systolic diameter and LV EF) were similar between SSc and HC (table1). 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). LVESV was significantly increased in SSc (44.3±7.3 vs 37.8±2.4; SSc vs HC, p< 0.001)
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). There was a trend for decreasing left ventricular strain and increasing LEVSV in 1 year analysis of SSc patients but it did not reach statistical significance.
Conclusion:
SSc is associated with myocardial systolic dysfunction. Both deformation analysis by STE-based strain imaging and end systolic left ventricular volume analysis by real time 3-D echocardiography are promising modalities that allow us for non-invasive, comprehensive analysis of early deterioration in biventricular systolic function in patients with SSc.
Table1. Speckle tracking echocardiography (STE) and real time 3-D echocardiography results of SSc patiens and healthy controls.
|
|
SSc n=48 |
HC n=25 |
p value |
|
LV longitudinal peak systolic strain (%) |
13.3± 0.82 |
20.35±3.05 |
0.0001 |
|
LV strain rate (1/s) |
0.91±0.21 |
1.70±0.47 |
0.0001 |
|
RV longitudinal peak systolic strain (%) |
11.68±1.61 |
14.63±2.35 |
0.001 |
|
RV strain rate (1/s) |
0.31±0.01 |
2.73±0.4 |
0.0001 |
|
LVEDV (ml) |
104.6±16.2 |
106±17.5 |
0.63 |
|
LVESV (ml) |
44.3±7.3 |
37.8±2.4 |
0.0001 |
Values were presented as mean ±SD. LV; left ventricul, RV; right ventricul, LVEDV;left ventricular end diastolic volume,LVESV; left ventricular end systolic volume
Disclosure: S. Yavuz, None; T. Sahin, None; S. Yurdakul, None; N. Yilmaz, None; S. Ertekin, None.
To cite this abstract in AMA style:
Yavuz S, Sahin T, Yurdakul S, Yilmaz N, Ertekin S. Subclinical Biventricular Systolic Function Is Impaired in Patients with Systemic Sclerosis with Real Time 3-D Echpcardiography: 1 Year Follow-up Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/subclinical-biventricular-systolic-function-is-impaired-in-patients-with-systemic-sclerosis-with-real-time-3-d-echpcardiography-1-year-follow-up-study/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/subclinical-biventricular-systolic-function-is-impaired-in-patients-with-systemic-sclerosis-with-real-time-3-d-echpcardiography-1-year-follow-up-study/