Tissue Doppler echocardiography detected significantly lower systolic strain-rate in systemic sclerosis patients compared to matched controls (1.7 vs 3.8 cm-1, p<0.0001).
Case-Control (n=32)
Does Tissue Doppler echocardiography detect early myocardial contractility alterations in systemic sclerosis patients with normal LVEF compared to matched controls?
Tissue Doppler echocardiography can detect early subclinical myocardial contractility impairment in systemic sclerosis patients who have normal left ventricular ejection fraction by conventional methods.
Absolute Event Rate: 1.7% vs 3.8%
p-value: p=<0.0001
AIMS: Systemic sclerosis (SSc) is a connective tissue disorder characterized by frequent myocardial involvement. Alteration in left ventricular (LV) function is reported to be rare; however, it may be underestimated by conventional measurements. Our aim was to prospectively investigate LV function in SSc patients, using Tissue Doppler echocardiography (TDE), a modern and accurate method of assessing myocardial function. METHODS AND RESULTS: Seventeen consecutive SSc patients with normal cardiac examination, pulmonary artery pressure (PAP) and radionuclide LV ejection fraction (EF) were prospectively investigated. Myocardial perfusion was investigated using single-photon-emission computerized tomography (SPECT). Echocardiography (ECHO), systolic and diastolic strain-rate (SR) measured in the posterior wall by TDE were used to investigate myocardial function, and compared with results of 15 matched controls. All patients (53+/-8 years; 14 women; systolic PAP 33+/-6 mmHg; LVEF 67+/-8%) had myocardial SPECT perfusion abnormalities. Despite normal ECHO, they had lower systolic SR than controls (1.7+/-0.5 versus 3.8+/-1.7 cm-1, p<0.0001), and lower diastolic SR (3.7+/-1.5 versus 5.6+/-1.2 cm-1, p=0.0004). Ten SSc patients had reduced systolic SR<1.7 cm-1 and 11 reduced diastolic SR<3.5 cm-1. CONCLUSION: Frequent abnormal myocardial perfusion is confirmed in SSc patients. Reduced contractility is also frequent as detected by TDE, despite normal radionuclide LVEF.
Meune et al. (Tue,) conducted a case-control in Systemic sclerosis (n=32). Systemic sclerosis vs. Matched controls was evaluated on Systolic strain-rate (SR) measured in the posterior wall by TDE (p=<0.0001). Tissue Doppler echocardiography detected significantly lower systolic strain-rate in systemic sclerosis patients compared to matched controls (1.7 vs 3.8 cm-1, p<0.0001).