Erschienen in:
09.10.2017 | Original Article
Cardiac involvement in undifferentiated connective tissue disease at risk for systemic sclerosis (otherwise referred to as very early–early systemic sclerosis): a TDI study
verfasst von:
Michele D’Alto, Antonella Riccardi, Paola Argiento, Ilaria Di Stefano, Emanuele Romeo, Agostino Mattera Iacono, Antonello D’Andrea, Serena Fasano, Alessandro Sanduzzi, Marialuisa Bocchino, Ludovico Docimo, Salvatore Tolone, Maria Giovanna Russo, Gabriele Valentini
Erschienen in:
Clinical and Experimental Medicine
|
Ausgabe 2/2018
Einloggen, um Zugang zu erhalten
Abstract
Undifferentiated connective tissue disease at risk for systemic sclerosis (UCTD-risk-SSc), otherwise referred to as very early–early SSc, is a condition characterized by Raynaud’s phenomenon with serum SSc marker autoantibodies and/or typical capillaroscopic findings and unsatisfying classification criteria for the disease. The aim of the present study was to assess the prevalence of right (RV) or left ventricular (LV) systolic and/or diastolic dysfunction by standard echocardiography and tissue Doppler imaging (TDI). Thirty patients with UCTD-risk-SSc (28 female, mean age 47 ± 13 years, range 21–70) and 30 age- and sex-matched controls underwent cardiac assessment by standard echocardiography and TDI. UCTD-risk-SSc patients and controls did not show any difference at standard echocardiography. Despite results falling within the respective normal ranges, TDI pointed out a mild impairment of LV and RV diastolic (E
m 15 ± 4 vs. 19 ± 5, p = 0.0004; E/E
m 6.1 ± 1.7 vs. 4.8 ± 1.2, p = 0.001; E
t 14 ± 3 vs. 16 ± 2, p = 0.02; E
t/A
t 0.9 ± 0.4 vs. 1.3 ± 0.3, p = 0.002; E/E
t 3.5 ± 1.2 vs. 4.2 ± 0.9, p = 0.02) and systolic function (S
m 13 ± 3 vs. 15 ± 2 cm/s, p < 0.0003; S
t 14 ± 2 vs. 16 ± 3 cm/s, p < 0.0001) and increased estimated pulmonary artery wedge pressure (9 ± 2 vs. 8 ± 1, p = 0.001) in UCTD-risk-SSc patients as compared to controls. Notably, a statistically significant difference also emerged in the prevalence of TDI detected E′/A′t, (71% of UCTD-risk-SSc patients vs. 19% of controls; p < 0.0001). Our study shows that UCTD-risk-SSc patients show a previously unrecognized, mild biventricular systolic and diastolic dysfunction as compared to controls. The pathophysiologic meaning as well the predictive value of developing overt SSc await to be elucidated.