Document Detail


Early impairment of myocardial function in systemic sclerosis: non-invasive assessment by Doppler myocardial and strain rate imaging.
MedLine Citation:
PMID:  16293527     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aim of the present study was to analyze both left (LV) and right ventricular (RV) myocardial function in patients with Systemic Sclerosis (SSc), and their relation to other instrumental features of the disease. METHODS AND RESULTS: Twenty-five healthy subjects and 23 age- and sex-comparable asymptomatic patients classified as having either diffuse (11 patients) or limited form (12 patients) of SSc underwent clinical examination, serological tests, high-resolution chest-CT, standard Doppler echo, pulsed Doppler myocardial imaging (DMI) and strain rate imaging (SRI) of both LV and RV lateral walls. By chest-CT, 11 patients showed interstitial pulmonary fibrosis. Serological antibodies analysis detected anti-centromere pattern in 8 patients, and anti Scl-70 in 15 patients. LV diameters and ejection fraction were comparable between the two groups, while RV end-diastolic diameter was increased in SSc (p<0.01). Tricuspid inflow E/A ratio was slightly decreased in SSc (p<0.01), while systolic pulmonary pressure was increased (p<0.001). Pulsed DMI detected in SSc impaired myocardial RV early-diastolic (Em) peak velocity (p<0.0001), and prolonged myocardial time intervals at tricuspid annulus level. In SSc, peak systolic RV SR and strain were both reduced in basal, middle and apical RV lateral free walls, and in basal and middle LV lateral walls. By multivariate analysis, independent inverse association of RV peak Em velocity with both Rodnan Skin Score (p<0.0005) and pulmonary systolic pressure (p<0.0001), as well as independent inverse correlation of the same RV peak Em velocity with pulmonary fibrosis (<0.0005) in SSc patients were observed. In addition, RV Em was an independent predictor of the anti Scl-70 antibody pattern (p<0.001). CONCLUSIONS: Pulsed DMI and SRI are valuable non-invasive and easy-repeatable tools for detecting RV and LV myocardial involvement caused by SSc, and may therefore be useful to early identify patients with more diffused and severe form of SSc.
Authors:
Antonello D'Andrea; Stefano Stisi; Salvatore Bellissimo; Francesco Vigorito; Fortunato Scotto di Uccio; Nicola Tozzi; Francesco Moscato; Enrica Pezzullo; Raffaele Calabrò; Marino Scherillo
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2005-04-07
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  6     ISSN:  1525-2167     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-11-18     Completed Date:  2006-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  407-18     Citation Subset:  IM    
Affiliation:
Department of Interventional Cardiology, G. Rummo Hospital, Benevento, Italy. adandrea@synapsis.it
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MeSH Terms
Descriptor/Qualifier:
Autoantibodies / analysis,  immunology
Diastole
Echocardiography, Doppler, Pulsed*
Female
Heart / physiopathology*
Heart Ventricles / pathology,  physiopathology,  ultrasonography
Humans
Hypertension, Pulmonary / pathology,  physiopathology,  ultrasonography
Male
Middle Aged
Multivariate Analysis
Nuclear Proteins / analysis,  immunology
Pulmonary Fibrosis / pathology,  physiopathology,  ultrasonography
Reproducibility of Results
Scleroderma, Systemic / diagnosis,  physiopathology*,  ultrasonography*
Sensitivity and Specificity
Systole
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/Nuclear Proteins; 0/Scl 70 antigen, human

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