Key result
Systemic sclerosis patients with preserved LVEF had significantly lower global longitudinal peak systolic strain compared to healthy controls (-19.0% vs. -21.1%; P=0.008).
Why the study?
Does two-dimensional speckle-tracking echocardiography detect early LV systolic impairment in patients with systemic sclerosis having preserved LVEF compared to healthy subjects?
Case-Control (n=44)
Does two-dimensional speckle-tracking echocardiography detect early LV systolic impairment in patients with systemic sclerosis having preserved LVEF compared to healthy subjects?
Absolute Event Rate: -19% vs -21.1%
p-value: p=0.008
Two-dimensional speckle-tracking echocardiography can detect early subclinical left ventricular systolic impairment, primarily in basal segments, in patients with systemic sclerosis and preserved LVEF.
Speckle-tracking strain may detect subclinical LV impairment in systemic sclerosis with preserved LVEF; hypothesis-generating, requires prospective validation before clinical adoption.
AIMS: Myocardial involvement is associated with poor prognosis in patients with systemic sclerosis (SSc). Two-dimensional speckle-tracking echocardiography (STE) is a powerful novel modality for the assessment of subclinical cardiac left ventricular (LV) dysfunction that, so far, has not been investigated in SSc patients. The aim of this study was to evaluate deformation analyses derived from STE for early detection of LV systolic dysfunction in patients with SSc having preserved left ventricular ejection fraction (LVEF). METHODS AND RESULTS: Twenty-two patients with SSc (57.1 ± 13.3 years, LVEF 64 ± 3.1%, mean time of 5.4 ± 4.6 years from diagnosis) and 22 gender- and age-matched healthy subjects (57.4 ± 14.0 years, LVEF 65 ± 2.7%) underwent echocardiography with STE to assess global and regional LV function. The global longitudinal 2D peak systolic strain (PSS) of the left ventricle was significantly lower in the SSc group compared with controls: -19.0 ± 2.4 vs. -21.1 ± 2.5% (P = 0.008). This was mainly driven by a reduced strain in the basal segments. Strain in the medial segments and in the apex did not differ significantly. In addition, there was a significant difference between both groups regarding the global longitudinal PSS rate of the left ventricle (-1.19 ± 0.18 vs. -1.43 ± 0.26 s(-1), P = 0.001). CONCLUSION: LV deformation analysis by STE is a sensitive method to detect early LV systolic impairment primarily in the basal segments in patients with SSc having preserved LVEF.
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Spethmann et al. (2012) conducted a case-control in Systemic sclerosis (n=44). Systemic sclerosis vs. Healthy subjects was evaluated on Global longitudinal 2D peak systolic strain (PSS) of the left ventricle (p=0.008). Systemic sclerosis patients with preserved LVEF had significantly lower global longitudinal peak systolic strain compared to healthy controls (-19.0% vs. -21.1%; P=0.008).
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