Key result
Systemic sclerosis was associated with significantly lower left atrial global longitudinal strain (P=0.028) and ejection fraction (P=0.001) compared to healthy controls.
Why the study?
Cardiac involvement predicts poor prognosis in systemic sclerosis, making preclinical diagnosis crucial, and 2D-STE may aid early detection of cardiac mechanical abnormalities.
Does two-dimensional speckle tracking echocardiography detect early cardiac mechanical function abnormalities in patients with systemic sclerosis compared to healthy individuals?
Case-Control (n=74)
Does two-dimensional speckle tracking echocardiography detect early cardiac mechanical function abnormalities in patients with systemic sclerosis compared to healthy individuals?
Two-dimensional speckle tracking echocardiography can detect early subclinical cardiac mechanical dysfunction, particularly in the atria, in patients with systemic sclerosis.
Objective: Cardiac involvement is a predictor of poor prognosis in patients with systemic sclerosis (SSc); therefore, preclinical diagnosis of heart involvement is crucial. Two-dimensional speckle tracking echocardiography (2D-STE), a method for evaluating the myocardial strain, could be helpful for the early diagnosis of cardiac mechanical function abnormalities. In this study, the simultaneous evaluation of all cardiac chambers was studied in patients with SSc, compared with normal individuals. Methods: The results of transthoracic echocardiography (TTE) and 2D-STE of 37 patients with SSc and 37 healthy individuals and the longitudinal strain (LS) of all chambers was precisely evaluated. The collected data were analyzed using SPSS version 16, and independent-sample t test and Chi-square test were used for comparison between the groups. Results: The mean ± SD of the participants’ age was 45.7 ± 11.54 (range of 17 to 68) years; most of them were women (75.7%). TTE showed higher left atrial (LA) volume (p < 0.001), right atrial (RA) area (p = 0.007), the severity of ventricular dysfunction (p < 0.05) and inferior vena cava diameter (p = 0.005), compared with the control group. Spectral and tissue Doppler echocardiography showed higher systolic pulmonary arterial pressure (sPAP) and mitral A wave velocity, and lower E/A ratio, E’ velocity of left ventricular (LV) septal and lateral wall in the case group (p < 0.05). Color Doppler echocardiography showed a higher frequency of valvular regurgitation in the case group (p < 0.05). The results of 2D-STE showed lower LA roof LS (p < 0.001), LA average LS (p = 0.015), LA global LS (p = 0.028), and LA ejection fraction (LAEF) (p = 0.001), lower mean RA left wall (p = 0.048) and EF (p < 0.001), and higher RV global LS in the case group (p = 0.025). Conclusions: Simultaneous evaluation of all cardiac chambers by 2D-STE provides valuable information about the myocardial involvement in patients with SSc. Therefore, it is suggested to use this method for the early diagnosis of cardiac involvement in such patients.
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Sharifkazemi et al. (2022) conducted a case-control in Systemic sclerosis (n=74). Systemic sclerosis vs. Healthy individuals was evaluated on Left atrial global longitudinal strain (p=0.028). Systemic sclerosis was associated with significantly lower left atrial global longitudinal strain (P=0.028) and ejection fraction (P=0.001) compared to healthy controls.
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