Early right ventricular systolic dysfunction in patients with systemic sclerosis without pulmonary hypertension: a Doppler Tissue and Speckle Tracking echocardiography study

Sebastian Schattke,Gert Baumann,Fabian Knebel,Andrea Grohmann,Friederike Kmezik,Henryk Dreger,Gabriela Riemekasten,Adrian C Borges

doi:10.1186/1476-7120-8-3

Sebastian Schattke, Gert Baumann + Show 6 more

Open Access

https://doi.org/10.1186/1476-7120-8-3

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Abstract

BackgroundIsovolumetric acceleration (IVA) is a novel tissue Doppler parameter for the assessment of systolic function. The aim of this study was to evaluate IVA as an early parameter for the detection of right ventricular (RV) systolic dysfunction in patients with systemic sclerosis (SSc) without pulmonary hypertension.Methods22 patients and 22 gender- and age-matched healthy subjects underwent standard echocardiography with tissue Doppler imaging (TDI) and speckle tracking strain to assess RV function.ResultsTricuspid annular plane systolic excursion (TAPSE) (23.2 ± 4.1 mm vs. 26.5 ± 2.9 mm, p < 0.006), peak myocardial systolic velocity (Sm) (11.6 ± 2.3 cm/s vs. 13.9 ± 2.7 cm/s, p = 0.005), isovolumetric contraction velocity (IVV) (10.3 ± 3 cm/s vs. 14.8 ± 3 cm/s, p < 0.001) and IVA (2.3 ± 0.4 m/s2 vs. 4.1 ± 0.8 m/s2, p < 0.001) were significant lower in the patient group. IVA was the best parameter to predict early systolic dysfunction with an area under the curve of 0.988.ConclusionIVA is a useful tool with high-predictive power to detect early right ventricular systolic impairment in patients with SSc and without pulmonary hypertension.

Highlights

Isovolumetric acceleration (IVA) is a novel tissue Doppler parameter for the assessment of systolic function
In 10 patients with diffuse form (91%) and 8 patients with limited form (73%) the DLCO was less than 80% of the predicted value
Tricuspid annular plane systolic excursion (TAPSE) as a parameter for right ventricular (RV) systolic function measured in M-mode was significantly smaller in patients with systemic sclerosis (SSc) compared to the control subjects (23.2 ± 4.1 mm vs. 26.5 ± 2.9 mm, p = 0.006)

Summary

Introduction

Isovolumetric acceleration (IVA) is a novel tissue Doppler parameter for the assessment of systolic function. The aim of this study was to evaluate IVA as an early parameter for the detection of right ventricular (RV) systolic dysfunction in patients with systemic sclerosis (SSc) without pulmonary hypertension. Systemic sclerosis is a connective tissue disease characterized by vascular inflammation and fibrosis. Primary myocardial involvement and pulmonary hypertension are common in SSc. According to histological and clinical studies, cardiac involvement occurs in up to 80% of SSc patients [3,6,7,8]. According to histological and clinical studies, cardiac involvement occurs in up to 80% of SSc patients [3,6,7,8]

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