Echocardiographic follow-up of patients with systemic sclerosis by 2D speckle tracking echocardiography of the left ventricleReportar como inadecuado

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Cardiovascular Ultrasound

, 12:13

First Online: 29 March 2014Received: 18 February 2014Accepted: 21 March 2014


BackgroundSubclinical myocardial involvement is common in systemic sclerosis SSc and associated with poor prognosis. Early detection, particularly during follow-up, is important. Two-dimensional speckle tracking echocardiography STE has already been shown to detect early left ventricular systolic impairment in SSc patients with advanced disease. The aim of this study was to assess the ability of STE to diagnose changes in left ventricular function in patients with SSc with preserved LV ejection fraction LVEF and normal pulmonary pressure over time.

MethodsThis single-center pilot study included nineteen SSc patients without pulmonary hypertension and preserved LVEF 55.2 ± 10.8 years, 13 women, mean modified Rodnan Skin Score of 8.2 ± 6.5, median disease duration 6 ± 4.5 years. We performed STE at baseline and after two years mean 756.6 ± 8.8 days. Pulmonary hypertension was ruled out in all patients by right heart catheterization average mean PAP 17.7 ± 3.5 mmHg.

ResultsThe LVEF remained unchanged 63.3 ± 4.2% vs. 63.2 ± 5.0%, P = ns, but the global longitudinal peak systolic strain of the left ventricle was significantly lower: baseline -22.0 ± 2.3% vs. follow-up -20.8 ± 2.1% P = 0.04. The regional analysis showed a heterogeneous distribution of segmental systolic dysfunction that did not match any particular coronary artery distribution. In contrast, the LV diastolic function remained stable during follow-up.

ConclusionSTE might be a sensititive and valuable method to detect early LV systolic impairment in patients with SSc and preserved LVEF during two years. Prospective evaluations are needed for prognostic implications of these changes.

KeywordsSystemic sclerosis Speckle tracking 2D strain Myocardial involvement Electronic supplementary materialThe online version of this article doi:10.1186-1476-7120-12-13 contains supplementary material, which is available to authorized users.

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Autor: Sebastian Spethmann - Karl Rieper - Gabriela Riemekasten - Adrian C Borges - Sebastian Schattke - Gerd-Ruediger Burmester -


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