Document Detail


Diastolic function of the heart in mixed connective tissue disease.
MedLine Citation:
PMID:  16865311     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The authors examined the right and left ventricle functions in patients with mixed connective tissue disease (MCTD) by Doppler echocardiography. Of 51 patients, 20 had temporary pulmonary arterial hypertension in their case history. According to our knowledge, this is the first study examining the use of Doppler echocardiography and tissue Doppler technique in MCTD patients. Of 51 MCTD patients, 20 had pulmonary arterial hypertension (PAH) in the past 2 years. Diameters of the right and left ventricle, systolic and diastolic blood pressure were measured both in the 51 MCTD patients and in the 30 control subjects (mean age 54.8+/-6.2 years in the case of patients and 54.2+/-8.8 years in the case of control subjects). To estimate the global ventricle functions, the myocardial performance index--as described by Tei et al. (J Am Soc Echocardiogr 6:838-874, 1996)--was applied, which reflects the ratio of the sum of the isovolumetric contraction and relaxation time as compared to the ejection time. The 20 MCTD patients with PAH received cyclophosphamide therapy for 1 year beside the pulse corticosteroid (CS) therapy. In the case of MCTD patients without PAH, different treatments were used: 12 out of 31 patients were treated with sulfasalazine, 5 of whom received a combination of CS and methotrexate, and 14 took nonsteroid antiinflammatory drugs. In the case of the 51 MCTD patients (20 with PAH and 31 without PAH), diastolic function disorder of the left ventricle was detected; the diastolic Ee/Aa velocity quotient of the lateral mitral anulus was lower (p<0.01), and the mean deceleration time was longer (p<0.001) than that of the control group. The Tei index demonstrated the damage of the global ventricle function. The Tei index of the right ventricle indicated global failure of the right ventricle function in the case of MCTD patients complicated with PAH (Tei index 0.36+/-0.07 in MCTD with PAH and 0.28+/-0.04 in MCTD without PAH, p<0.001). The right ventricle function of MCTD patients without PAH was no different from that of the control group. In the case of patients with MCTD, signs of the disorder of the left ventricle diastolic function were observed. Our results suggest that the global impairment of the left ventricle function is the consequence of the disease itself and not the side effect of the treatment. In the case of MCTD patients complicated with PAH, the signs of the right ventricle function impairment proved to be permanent.
Authors:
Judit Végh; Ida Hegedus; Gyula Szegedi; Margit Zeher; Edit Bodolay
Publication Detail:
Type:  Journal Article     Date:  2006-07-25
Journal Detail:
Title:  Clinical rheumatology     Volume:  26     ISSN:  0770-3198     ISO Abbreviation:  Clin. Rheumatol.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2006-12-22     Completed Date:  2007-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211469     Medline TA:  Clin Rheumatol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  176-81     Citation Subset:  IM    
Affiliation:
3rd Department of Internal Medicine, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. veghju@freemail.hu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Cyclophosphamide / therapeutic use
Diastole
Drug Therapy, Combination
Echocardiography, Doppler
Female
Glucocorticoids / therapeutic use
Heart Ventricles / drug effects,  pathology,  physiopathology
Humans
Hypertension, Pulmonary / complications,  drug therapy,  physiopathology*
Immunosuppressive Agents / therapeutic use
Male
Methotrexate / therapeutic use
Middle Aged
Mixed Connective Tissue Disease / complications,  drug therapy,  physiopathology*
Myocardium / pathology
Pulse Therapy, Drug
Severity of Illness Index
Sulfasalazine / therapeutic use
Ventricular Dysfunction, Left / drug therapy,  physiopathology*
Ventricular Dysfunction, Right / drug therapy,  physiopathology*
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Glucocorticoids; 0/Immunosuppressive Agents; 50-18-0/Cyclophosphamide; 59-05-2/Methotrexate; 599-79-1/Sulfasalazine

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