Abstract 12797: A Global Longitudinal Strain in Endocardial Layer Selectively Correlated With Left Ventricular Ejection in Systemic Autoimmune Disorder Patients: A Multi-layer Transthoracic Echocardiography Study

Abstract

Introduction: In patients with systemic autoimmune disorders (SAD), hemodynamic abnormalities such as pulmonary hypertension occur. Hypothesis: Some specific myocardial characteristics in SAD patients may precipitate hemodynamic abnormalities. Using myocardial multi-layer transthoracic echocardiography (TTE) analysis, we determine left ventricular (LV) myocardial characteristics in SAD patients, and compared LV ejection fraction (LVEF), estimated pulmonary arterial systolic pressure (ePASP) on TTE and serum brain natriuretic protein (BNP). Methods: Twenty SAD patients (18 female; mean age 49±18 years; systemic lupus erythematosus 35%; vasculitis 20%; scleroderma 5%, rheumatoid arthritis 5%, mixed connective tissue disease 5%) underwent TTE (Vivid E9, GE Healthcare). Apical 2-, 3-, and 4-chamber GLS views and parasternal short axis GCS view at the level of the papillary muscle was acquired. GLS was defined by averaging all 17 LV segments. GCS was defined as averaged LV segments at the level of papillary muscle. Furthermore strain measurements (absolute values) of whole, endocardial, and epicardial layers were performed using Echo PAC version 113 (GE Healthcare). Results: There was no significant correlation between GLS (whole, endocardial, and epicardial layers) and LVEF, ePASP, and BNP, respectively. GCS was significantly negatively correlated with serum BNP (R=-0.606 (whole), -0.452 (endocardial) and -0.447 (epicardial layer)). GCS in whole and epicardial layer was significantly negative correlated with ePASP (-0.528 (whole) and -0.457 (epicardial layer)). Only GCS in endocardial layer was significantly positive correlated with LVEF (R=0.466). Conclusions: In SAD patients, GCS significantly correlated with cardiac function and, especially in the endocardial layer selectively and positively correlated with LVEF. These specific myocardial characteristics in SAD patients may precipitate hemodynamic abnormalities.