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Regional diastolic function by tissue Doppler echocardiography in systemic sclerosis: correlation with clinical variables

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Abstract

The incidence of left ventricular (LV) diastolic dysfunction is increased in systemic sclerosis (SSc), while systolic dysfunction is present in a small percentage of patients. The aim of this study was to asses the LV “regional” diastolic abnormalities in SSc patients by the mean of Doppler tissue imaging (DTI). Echocardiographic echo-Doppler (DE) and DTI parameters were analyzed for 67 SSc patients: abnormal E/A ratio at DE was detected in 24, while abnormal e/a at DTI was observed in 41. A significant prevalence of DTI diastolic abnormalities in the segments reflecting longitudinal versus those reflecting radial LV motion was found. The segments of the basal regions of LV myocardium were significantly more involved than those of the middle portion. Linear correlation was observed between the extent of the diastolic abnormalities and the duration of disease. Longitudinal myocardial systolic velocities were significantly reduced in patients with abnormal e/a DTI.

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References

  1. D’Angelo WA, Fries JF, Masi AT, Shulman LE (1969) Pathologic observations in systemic sclerosis (scleroderma). Am J Med 46:428–440

    Article  PubMed  Google Scholar 

  2. Follansbee W, Curtiss EE, Medsger T, Steen V, Uretsky BF, Owens GR et al (1984) Physiologic abnormalities of cardiac function in progressive systemic sclerosis with diffuse scleroderma. N Engl Med 310:142–148

    Article  CAS  Google Scholar 

  3. Gottdienner J, Routsoupoulos H, Tecker J (1979) Echocardiographic identification of cardiac abnormality in scleroderma andrelated disorders. Am J Med 66:391–398

    Article  Google Scholar 

  4. Medsger TA Jr, Masi AT, Rodnan GP, Benedek TG, Robinson H (1971) Survival with systemic sclerosis (scleroderma). A life-table analysis of clinical and demographic factors in 309 patients. Ann Intern Med 75:369–376

    PubMed  Google Scholar 

  5. Steen VD, Follansbee WP, Conte CG, Medsger TA Jr (1996) Thallium perfusion defects predict subsequent cardiac dysfunction in patients with systemic sclerosis. Arthritis Rheum 39:677–681

    Article  PubMed  CAS  Google Scholar 

  6. Ioannidis JP, Vlachoyiannopoulos PG, Haidich AB, Medsger TA Jr, Lucas M, Michet CJ et al (2005) Mortality in systemic sclerosis: an international meta-analysis of individual patient data. Am J Med 118:2–10

    Article  PubMed  Google Scholar 

  7. Siegel RJ, O’Connor B, Mane I, Criley JM (1984) Left ventricular function at rest and durino Raud’s phenomenon in patients with scleroderma. Am Heart J 108:1469–1476

    Article  PubMed  CAS  Google Scholar 

  8. Ferri C, Giuggioli D, Sebastiani M, Colaci M, Emdin M (2005) Heart involvement and systemic sclerosis. Lupus 14:702–707

    Article  PubMed  CAS  Google Scholar 

  9. Aguglia G, Sgreccia A, Bernardo ML, Carmenini E, Giusti De Marle M, Reali A et al (2001) Left ventricular diastolic function in systemic sclerosis. J Rheumatol 28:1563–1567

    PubMed  CAS  Google Scholar 

  10. Kazzam E, Waldenstrom A, Landelius J, Hallegren R, Arvidson A, Caidhal K (1990) Non-invasive assessment of left ventricular diastolic function in patients with systemic sclerosis. J Intern Med 228:183–192

    Article  PubMed  CAS  Google Scholar 

  11. Maione S, Valentini G, Giunta A, Migliaresi S, Itri F, Picillo U et al (1991) Evaluation of cardiac structures and function in systemic sclerosis by Doppler echocardiography. Cardiology 79:165–171

    Article  PubMed  CAS  Google Scholar 

  12. Valentini G, Vitale DF, Giunta A, Maione S, Gerundo G, Arnese MR et al (1996) Diastolic abnormalities in systemic sclerosis: evidence for associated defective cardiac functional reserve. Ann Rheum Dis 55:455–460

    Article  PubMed  CAS  Google Scholar 

  13. Giunta A, Tirri E, Maione S, Cangianiello S, Mele A, De Luca A et al (2000) Right ventricular diastolic abnormalities in systemic sclerosis. Relation to left ventricular involvement and pulmonary hypertension. Ann Rheum Dis 59:94–98

    Article  PubMed  CAS  Google Scholar 

  14. Follansbee WP, Miller TR, Curtiss EI, Orie JE, Bernstein RL, Kiernan JM et al (1990) A controlled clinicopathologic study of miocardial fibrosis in systemic sclerosis (scleroderma). J Rheumatol 17:656–662

    PubMed  CAS  Google Scholar 

  15. Nakajima K, Taki J, Kawano M, Higuchi T, Sato S, Nishijima C et al (2001) Diastolic dysfunction in patients with systemic sclerosis detected by gated myocardial perfusion SPECT: an early sign of cardiac involvement. J Nucl Med 42:183–188

    PubMed  CAS  Google Scholar 

  16. Plazak W, Zabinska-Plazak E, Wojas-Pelc A, Podolec P, Olszowska M, Tracz W et al (2002) Heart structure and function in systemic sclerosis. Eur J Dermatol 12:257–262

    PubMed  Google Scholar 

  17. Armstrong GP, Whalley GA, Doughty RN, Gamble GD, Flett SM, Tan PL et al (1996) Left ventricular function in scleroderma. Br J Rheumatol 35:983–988

    Article  PubMed  CAS  Google Scholar 

  18. Fernandes F, Ramires FJ, Arteaga E, Ianni BM, Bonfa ES, Mady C (2003) Cardiac remodeling in patients with systemic sclerosis with no signs or symptoms of heart failure: an endomyocardial biopsy study. J Card Fail 9:311–317

    Article  PubMed  Google Scholar 

  19. Maione S, Cuomo G, Giunta A, Tanturri de Horatio L, La Montagna G, Manguso F et al (2005) Echocardiographic alterations in systemic sclerosis: a longitudinal study. Semin Arthritis Rheum 34:721–727

    Article  PubMed  Google Scholar 

  20. Isaaz K (2002) Tissue Doppler imaging for the assessment of left ventricular systolic and diastolic functions. Curr Opin Cardiol 17:431–442

    Article  PubMed  Google Scholar 

  21. Subcommittee for Scleroderma Criteria of the American Rheumatism Association Dignostic, Therapeutic Criteria Committee (1980) Preliminary criteria for classification of systemic sclerosis (scleroderma). Arthritis Rheum 23:581–590

    Article  Google Scholar 

  22. LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA Jr et al (1988) Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol 15:202–205

    PubMed  CAS  Google Scholar 

  23. Valentini G, Silman AJ, Veale D (2003) Assessment of disease activity. Clin Exp Rehumatol 21(Suppl 29):39–41

    Google Scholar 

  24. Medseger TA, Bombardieri S, Czirjak L, Scorza R, Della Rossa A, Bencivelly W (2003) Assessment of severity and prognosis. Clin Exp Rehumatol 21(Suppl 29):42–46

    Google Scholar 

  25. Galiuto L, Ignone G, DeMaria AN (1998) Contraction and relaxation velocities of the normal left ventricle using pulsed-wave tissue Doppler echocardiography. Am J Cardiol 81:609–614

    Article  PubMed  CAS  Google Scholar 

  26. Garcia-Fernandez MA, Azevedo J, Moreno M, Bermejo J, Perez-Castellano N, Puerta P et al (1999) Regional diastolic function in ischaemic heart disease using pulsed wave Doppler tissue imaging. Eur Heart J 20:496–505

    Article  PubMed  CAS  Google Scholar 

  27. Donovan CL, Armstrong WF, Bach DS (1995) Quantitative Doppler tissue imaging of the left ventricular myocardium: validation in normal subjects. Am Heart J 130:100–104

    Article  PubMed  CAS  Google Scholar 

  28. Pellerin D, Sharma R, Elliott P, Veyrat C (2003) Tissue Doppler, strain, and strain rate echocardiography for the assessment of left and right systolic ventricular function. Heart 89(Suppl 3):9–17

    Google Scholar 

  29. Coucelo J, Azevedo J, Felizardo A, Soares L, Pereira J, Mota A et al (2000) Myocardial architecture, texture and left ventricular heterogeneity in the pulsed Doppler tissue imaging pattern. Rev Port Cardiol 19:217–224

    PubMed  CAS  Google Scholar 

  30. Di Bello V, Ferri C, Giorgi D, Bianchi M, Bertini A, Martini A et al (1999) Ultrasonic videodensitometric analysis in scleroderma heart disease. Coron Artery Dis 10:103–110

    PubMed  CAS  Google Scholar 

  31. Derumeaux G, Ovize M, Loufoua J, Pontier G, Andre-Fouet X, Cribier A (2000) Assessment of nonuniformity of transmural myocardial velocities by color-coded tissue Doppler imaging: characterization of normal, ischemic, and stunned myocardium. Circulation 101:1390–1395

    PubMed  CAS  Google Scholar 

  32. Gullulu S, Kaderli AA, Ekbul A, Ozdemir B, Baran I, Gullulu M et al (2005) Tissue Doppler echocardiography and myocardial performance index in patients with scleroderma. J Int Med Res 33:417–424

    PubMed  CAS  Google Scholar 

  33. Meune C, Allanore Y, Pascal O, Devaux JY, Dessault O, Duboc D et al (2005) Myocardial contractility is early affected in systemic sclerosis: a tissue Doppler echocardiography study. Eur J Echocardiogr 6:351–357

    Article  PubMed  Google Scholar 

  34. D’Andrea A, Stisi S, Bellissimo S, Vigorito F, Scotto di Uccio F, Tozzi N et al (2005) Early impairment of myocardial function in systemic sclerosis: non-invasive assessment by Doppler myocardial and strain rate imaging. Eur J Echocardiogr 6:407–418

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Departments of Clinical Immunology and Allergy, Sapienza University of Rome, Viale dell’Università 37, 00185, Rome, Italy

    Edoardo Rosato, Michele Proietti, Simonetta Pisarri & Felice Salsano

  2. Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University “Federico II”, Naples, Italy

    Stefania Maione, Anna Giunta, Luca Fontanella, Laura Tanturri de Horatio & Francesco Cacciatore

  3. Department of Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy

    Antonio Vitarelli

Authors
  1. Edoardo Rosato
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  2. Stefania Maione
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  3. Antonio Vitarelli
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  4. Anna Giunta
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  5. Luca Fontanella
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  6. Laura Tanturri de Horatio
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  10. Felice Salsano
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Correspondence to Felice Salsano.

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Rosato, E., Maione, S., Vitarelli, A. et al. Regional diastolic function by tissue Doppler echocardiography in systemic sclerosis: correlation with clinical variables. Rheumatol Int 29, 913–919 (2009). https://doi.org/10.1007/s00296-008-0827-x

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  • DOI: https://doi.org/10.1007/s00296-008-0827-x

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