Left atrial dysfunction detected by speckle tracking in patients with systemic sclerosis

Cardiovascular Ultrasound

Research

Albert Varga¹  Gergely Agoston¹  Antonella Moreo²  Marco Matucci Cerinic³  Luigi Paolo Badano⁴  Denisa Muraru⁴  Marcelo Haertel Miglioranza⁵  Maria Caputo⁶  Sergio Mondillo⁶  Alberto Moggi Pignone⁷  Luna Gargani⁸  Eugenio Picano⁸  Rosa Sicari⁸ 

[1] 2nd Department of Medicine and Cardiology Center, University of Szeged, Korányi Fasor 6, 6720, Szeged, Hungary;Cardiology Department, Niguarda Ca’ Granda Hospital, Milan, Italy;Department of Biomedicine, Division of Rheumatology, University of Florence, Florence, Italy;Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Pisa, Italy;Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Pisa, Italy;Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil;Department of Cardiovascular Diseases, University of Siena, Siena, Italy;Department of Internal Medicine, University of Florence, Florence, Italy;Institute of Clinical Physiology, National Council of Research, Pisa, Italy;

关键词: Left Atrial;    Tissue Doppler Imaging;    Cardiac Involvement;    Left Atrial Volume;    Pulmonary Artery Systolic Pressure;   

DOI  :  10.1186/1476-7120-12-30

 received in 2014-05-01, accepted in 2014-07-28,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundCardiac involvement is a relevant clinical finding in systemic sclerosis (SSc) and is associated with poor prognosis. Left atrial (LA) remodeling and/or dysfunction can be an early sign of diastolic dysfunction. Two-dimensional speckle tracking echocardiography (STE) is a novel and promising tool for detecting very early changes in LA myocardial performance.AimTo assess whether STE strain parameters may detect early alterations in LA function in SSc patients.MethodsForty-two SSc patients (Group 1, age 50 ± 14 years, 95% females) without clinical evidence for cardiac involvement and 42 age- and gender-matched control subjects (Group 2, age 49 ± 13 years, 95% females) were evaluated with comprehensive 2D and Doppler echocardiography, including tissue Doppler imaging analysis. Positive peak left atrial longitudinal strain (ϵ pos peak), second positive left atrial longitudinal strain (sec ϵ pos peak), and negative left atrial longitudinal strain (ϵ neg peak) were measured using a 12-segment model for the LA, by commercially available semi-automated 2D speckle-tracking software (EchoPac PC version 108.1.4, GE Healthcare, Horten, Norway).ResultsAll SSc patients had a normal left ventricular ejection fraction (63.1 ± 4%). SSc patients did not differ from controls in E/A (Group 1 = 1.1 ± 0.4 vs Group 2 = 1.3 ± 0.4, p = .14) or pulmonary arterial systolic pressure (Group 1 = 24.1 ± 8 mmHg vs Group 2 = 21 ± 7 mmHg, p = .17). SSc patients did not show significantly different indexed LA volumes (Group 1 = 24.9 ± 5.3 ml/m2 vs Group 2 = 24.7 ± 4.4 ml/m2, p = .8), whereas E/e’ ratio was significantly higher in SSc (Group 1 = 7.6 ± 2.4 vs Group 2 = 6.5 ± 1.7, p<0.05), although still within normal values. LA strain values were significantly different between the two groups (ϵ pos peak Group 1 = 31.3 ± 4.2% vs Group 2 = 35.0 ± 7.6%, p < .01, sec ϵ pos peak Group 1 = 18.4 ± 4 vs Group 2 = 21.4 ± 7.6, p < 0.05).Conclusion2D speckle-tracking echocardiography is a sensitive tool to assess impairment of LA mechanics, which is detectable in absence of changes in LA size and volume, and may represent an early sign of cardiac involvement in patients with SSc.

【 授权许可】

CC BY   
© Agoston et al.; licensee BioMed Central Ltd. 2014