TY - JOUR
T1 - Disturbed right ventricular diastolic function in patients with systemic sclerosis
T2 - A Doppler tissue imaging study
AU - Lindqvist, Per
AU - Caidahl, Kenneth
AU - Neuman-Andersen, Grete
AU - Ozolins, Cecilia
AU - Rantapää-Dahlqvist, Solbritt
AU - Waldenström, Anders
AU - Kazzam, Elsadig
N1 - Funding Information:
This study was supported by the Swedish Heart and Lung Foundation, the Medical Faculty at Umeå University, the Swedish Medical Association, the Mälar Hospital (Eskilstuna) Research Fund, the Mid-Sweden Research and Development Centre (Västernorrland County Council) and the Swedish Medical Research Council
PY - 2005/8
Y1 - 2005/8
N2 - Background: Cardiopulmonary involvement in patients with systemic sclerosis (SSc) carries a poor prognosis, mainly due to pulmonary hypertension and right-heart failure. To date, right ventricular (RV) involvement has not been studied in detail. We therefore assessed RV function in patients with SSc and related the findings to the clinical features of the disease. Method: Twenty-six consecutive patients (21 women) with SSc (mean age, 56 ± 15 years [± SD]) and 25 healthy, age-matched control subjects (21 women) were studied. Doppler echocardiography including Doppler tissue imaging was used to evaluate cardiac function. Pulmonary function was also studied. Results: Compared with control subjects, RV free wall thickness (5.8 ± 1.7 mm vs 3.7 ± 1.1 mm, p < 0.001) and right atrial (RA) systolic area (15.9 ± 3.7 cm2 vs 13.0 ± 2.3 cm2, p < 0.01) were increased in patients with SSc, while the global early diastolic/atrial component velocity ratio was reduced (1.2 ± 0.4 vs 1.7 ± 0.6, p < 0.01). The global isovolumic relaxation time (IVRT) [64 ± 23 ms vs 39 ± 13 ms, p < 0.001] and regional IVRT (83 ± 40 ms vs 46 ± 24 ms, p < 0.001) were prolonged in patients vs control subjects, whereas the RV global filling time was reduced (454 ± 122 ms vs 548 ± 104 ms, p < 0.01). RV systolic function and pulmonary pressures at rest were similar in the two groups, but the pulmonary artery acceleration time was reduced (119 ± 34 ms vs 141 ± 29 ms, p < 0.05) in patients compared to control subjects. Left ventricular function did not differ between the two groups. Conclusion: Patients with SSc exhibit altered RV diastolic function together with an increase in RV wall thickness and RA area. These findings appear to be early markers of RV disturbance, probably in response to intermittent pulmonary arterial hypertension.
AB - Background: Cardiopulmonary involvement in patients with systemic sclerosis (SSc) carries a poor prognosis, mainly due to pulmonary hypertension and right-heart failure. To date, right ventricular (RV) involvement has not been studied in detail. We therefore assessed RV function in patients with SSc and related the findings to the clinical features of the disease. Method: Twenty-six consecutive patients (21 women) with SSc (mean age, 56 ± 15 years [± SD]) and 25 healthy, age-matched control subjects (21 women) were studied. Doppler echocardiography including Doppler tissue imaging was used to evaluate cardiac function. Pulmonary function was also studied. Results: Compared with control subjects, RV free wall thickness (5.8 ± 1.7 mm vs 3.7 ± 1.1 mm, p < 0.001) and right atrial (RA) systolic area (15.9 ± 3.7 cm2 vs 13.0 ± 2.3 cm2, p < 0.01) were increased in patients with SSc, while the global early diastolic/atrial component velocity ratio was reduced (1.2 ± 0.4 vs 1.7 ± 0.6, p < 0.01). The global isovolumic relaxation time (IVRT) [64 ± 23 ms vs 39 ± 13 ms, p < 0.001] and regional IVRT (83 ± 40 ms vs 46 ± 24 ms, p < 0.001) were prolonged in patients vs control subjects, whereas the RV global filling time was reduced (454 ± 122 ms vs 548 ± 104 ms, p < 0.01). RV systolic function and pulmonary pressures at rest were similar in the two groups, but the pulmonary artery acceleration time was reduced (119 ± 34 ms vs 141 ± 29 ms, p < 0.05) in patients compared to control subjects. Left ventricular function did not differ between the two groups. Conclusion: Patients with SSc exhibit altered RV diastolic function together with an increase in RV wall thickness and RA area. These findings appear to be early markers of RV disturbance, probably in response to intermittent pulmonary arterial hypertension.
KW - Diastolic function
KW - Doppler tissue imaging
KW - Echocardiography
KW - Right ventricle
KW - Systemic sclerosis
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U2 - 10.1378/chest.128.2.755
DO - 10.1378/chest.128.2.755
M3 - Article
C2 - 16100164
AN - SCOPUS:23744482623
SN - 0012-3692
VL - 128
SP - 755
EP - 763
JO - Chest
JF - Chest
IS - 2
ER -