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01.06.2015 | e-Herz: Original article

Right ventricular and atrial functions in systemic sclerosis patients without pulmonary hypertension

Speckle-tracking echocardiographic study

verfasst von: E. Durmus, M. Sunbul, MD, K. Tigen, T. Kivrak, G. Ozen, I. Sari, H. Direskeneli, Y. Basaran

Erschienen in: Herz | Ausgabe 4/2015

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Abstract

Background

Systemic sclerosis (SSc) is a systemic connective tissue disease and cardiac involvement is one of the most important causes of death. Right ventricular (RV) systolic dysfunction is a poor prognostic finding in SSc patients. Assessment of RV function has some difficulties because of its crescent shape and extensive trabeculations. Two-dimensional (2D) speckle-tracking echocardiography (STE) is an angle-independent quantitative technique to evaluate myocardial function. The aim of this study was to assess the RV and right atrial (RA) functions of SSc patients without pulmonary hypertension by using 2D STE.

Patients and methods

A total of 40 patients with SSc (mean age 48.5 ± 11.4 years, 28 female) and 40 healthy volunteers (mean age 45.9 ± 7.6 years, 21 female) were included in the study. All subjects underwent transthoracic echocardiography for evaluation of RV and RA functions with 2D STE.

Results

Although left ventricular systolic and diastolic functions, systolic pulmonary artery pressure (PAP), and RA measurements were similar in both groups, tricuspid annular plane systolic excursion (TAPSE) and maximum systolic myocardial velocity (S’) were decreased in SSc patients. The RV free wall global longitudinal strain (GLS) of SSc patients was lower than the controls (− 18.5 ± 4.9 % vs. − 21.8 ± 2.4 %, p < 0.001) and the RA reservoir and conduit functions were also decreased in SSc patients compared with controls (34.4 ± 9.9 % vs. 39.7 ± 11.2 %, p = 0.027 and 15.0 ± 5.7 % vs. 18.7 ± 6.4 %, p = 0.009, respectively). Disease duration was inversely correlated with RVGLS and TAPSE (r: − 0.416, p = 0.018 and r: − 0.383, p = 0.031, respectively).

Conclusion

The use of 2D STE can be helpful in the detection of impairment in RV and RA functions in SSc patients with normal PAP.

Medsger TA Jr (2001) Systemic sclerosis (scleroderma): clinical aspects. In: Koopman WJ (ed) Arthritis and allied conditions: a textbook of rheumatology, 14th edn. Lippincott Williams & Wilkins, Philadelphia, pp 1590–1624

Komócsi A, Vorobcsuk A, Faludi R et al (2012) The impact of cardiopulmonary manifestations on the mortality of SSc: a systematic review and meta-analysis of observational studies. Rheumatology (Oxford) 51:1027–1036

Kahan A, Allanore Y (2006) Primary myocardial involvement in systemic sclerosis. Rheumatology (Oxford) 45(Suppl 4):iv14–iv17

Rudski LG, Lai WW, Afilalo J et al (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23:685–713PubMedCrossRef

Meris A, Faletra F, Conca C et al (2010) Timing and magnitude of regional right ventricular function: a speckle tracking-derived strain study of normal subjects and patients with right ventricular dysfunction. J Am Soc Echocardiogr 23:823–831PubMedCrossRef

Masi AT, Rodnan GP, Medsger TA et al (1980) Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 23:581–590CrossRef

Cheitlin MD, Armstrong WF, Aurigemma GP et al (2003) ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). J Am Soc Echocardiogr 16:1091–1110PubMed

Sunbul M, Kepez A, Kivrak T et al (2013) Right ventricular longitudinal deformation parameters and exercise capacity. Herz. doi:10.1007/s00059-013-3842-y

Padeletti M, Cameli M, Lisi M et al (2012) Reference values of right atrial longitudinal strain imaging by two-dimensional speckle tracking. Echocardiography 29:147–152PubMedCrossRef

10.

Mor-Avi V, Lang RM, Badano LP et al (2011) Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. Eur J Echocardiogr 12:167–205PubMedCrossRef

11.

Muangchan C, Canadian Scleroderma Research Group, Baron M, Pope J (2013) The 15 % rule in scleroderma: the frequency of severe organ complications in systemic sclerosis. A systematic review. J Rheumatol 40:1545–1556PubMedCrossRef

12.

Gelber AC, Manno RL, Shah AA et al (2013) Race and association with disease manifestations and mortality in scleroderma: a 20-year experience at the Johns Hopkins Scleroderma Center and review of the literature. Medicine (Baltimore) 92:191–205

13.

Hsiao SH, Lee CY, Chang SM et al (2006) Right heart function in scleroderma: insights from myocardial Doppler tissue imaging. J Am Soc Echocardiogr 19:507–514PubMedCrossRef

14.

Pavlicek M, Wahl A, Rutz T et al (2011) Right ventricular systolic function assessment: rank of echocardiographic methods vs. cardiac magnetic resonance imaging. Eur J Echocardiogr 12:871–880PubMedCrossRef

15.

Lee CY, Chang SM, Hsiao SH et al (2007) Right heart function and scleroderma: insights from tricuspid annular plane systolic excursion. Echocardiography 24:118–125PubMedCrossRef

16.

Hardegree EL, Sachdev A, Fenstad ER et al (2013) Impaired left ventricular mechanics in pulmonary arterial hypertension: identification of a cohort at high risk. Circ Heart Fail 6:748–755PubMedCrossRef

17.

Cusmà Piccione M, Zito C, Bagnato G et al (2013) Role of 2D strain in the early identification of left ventricular dysfunction and in the risk stratification of systemic sclerosis patients. Cardiovasc Ultrasound 11:6CrossRef

18.

Spethmann S, Dreger H, Schattke S et al (2012) Two-dimensional speckle tracking of the left ventricle in patients with systemic sclerosis for an early detection of myocardial involvement. Eur Heart J Cardiovasc Imaging 13:863–870PubMedCrossRef

19.

Sunbul M, Durmus E, Kıvrak T et al (2013) Left ventricular strain and strain rate by two-dimensional speckle tracking echocardiography in patients with subclinical hypothyroidism. Eur Rev Med Pharmacol Sci 17:3323–3328PubMed

20.

Tanboğa IH, Işık T, Kaya A et al (2012) Two-dimensional strain imaging to predict the localization of an accessory pathway. Turk Kardiyol Dern Ars 40:108PubMedCrossRef

21.

Stefani L, Pedrizzetti G, De Luca A et al (2009) Real-time evaluation of longitudinal peak systolic strain (speckle tracking measurement) in left and right ventricles of athletes. Cardiovasc Ultrasound 7:17PubMedCentralPubMedCrossRef

22.

Simsek Z, Tas MH, Gunay E et al (2013) Speckle-tracking echocardiographic imaging of the right ventricular systolic and diastolic parameters in chronic exercise. Int J Cardiovasc Imaging 29:1265–1271PubMedCrossRef

23.

Altekin RE, Karakas MS, Yanikoglu A et al (2012) Determination of right ventricular dysfunction using the speckle tracking echocardiography method in patients with obstructive sleep apnea. Cardiol J 19:130–139PubMedCrossRef

24.

Padeletti M, Cameli M, Lisi M et al (2011) Right atrial speckle tracking analysis as a novel noninvasive method for pulmonary hemodynamics assessment in patients with chronic systolic heart failure. Echocardiography 28:658–664PubMedCrossRef

25.

Matias C, Isla LP, Vasconcelos M et al (2009) Speckle-tracking-derived strain and strain-rate analysis: a technique for the evaluation of early alterations in right ventricle systolic function in patients with systemic sclerosis and normal pulmonary artery pressure. J Cardiovasc Med (Hagerstown) 10:129–134CrossRef

26.

Schattke S, Knebel F, Grohmann A et al (2010) Early right ventricular systolic dysfunction in patients with systemic sclerosis without pulmonary hypertension: a Doppler tissue and speckle tracking echocardiography study. Cardiovasc Ultrasound 8:3. doi:10.1186/1476-7120-8-3PubMedCentralPubMedCrossRef

27.

Kepez A, Sunbul M, Kivrak T et al (2014) Evaluation of improvement in exercise capacity after pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension: correlation with echocardiographic parameters. Thorac Cardiovasc Surg 62:60–65PubMed

28.

Tedford RJ, Mudd JO, Girgis RE et al (2013) Right ventricular dysfunction in systemic sclerosis associated pulmonary arterial hypertension. Circ Heart Fail 6:953–963PubMedCrossRef

29.

Saraiva RM, Demirkol S, Buakhamsri A et al (2010) Left atrial strain measured by two-dimensional speckle tracking represents a new tool to evaluate left atrial function. J Am Soc Echocardiogr 2:172–180CrossRef

30.

Tsai WC, Lee CH, Lin CC et al (2009) Association of left atrial strain and strain rate assessed by speckle tracking echocardiography with paroxysmal atrial fibrillation. Echocardiography 26:1188–1194PubMedCrossRef

31.

Rosça M, Popescu BA, Beladan CC et al (2010) Left atrial dysfunction as a correlate of heart failure symptoms in hypertrophic cardiomyopathy. J Am Soc Echocardiogr 23:1090–1098PubMedCrossRef

32.

D’Andrea A, Caso P, Romano S et al (2009) Association between left atrial myocardial function and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy: a two-dimensional speckle strain study. Int J Cardiol 132:354–363CrossRef

Titel: Right ventricular and atrial functions in systemic sclerosis patients without pulmonary hypertension
Speckle-tracking echocardiographic study
verfasst von: E. Durmus
M. Sunbul, MD
K. Tigen
T. Kivrak
G. Ozen
I. Sari
H. Direskeneli
Y. Basaran
Publikationsdatum: 01.06.2015
Verlag: Urban & Vogel
Erschienen in: Herz / Ausgabe 4/2015
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-014-4113-2

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