Article

Echocardiographic alterations in systemic sclerosis: a longitudinal study.

Department of Clinical Medicine, Cardiovascular and Immunological Science, University of Naples Federico II, Italy.
Seminars in Arthritis and Rheumatism (impact factor: 4.97). 04/2005; 34(5):721-7. DOI:10.1016/j.semarthrit.2004.11.001
Source: PubMed

ABSTRACT To investigate the evolution of cardiac alterations in systemic sclerosis (SSc).
Echocardiographic and echo-Doppler findings from 77 unselected SSc patients were analyzed at the first clinical observation and after a follow-up period of 65 +/- 36 months. Data were compared with those obtained from 45 normal subjects matched for age and sex.
Baseline left ventricular (LV) systolic function was normal in all patients and controls while LV diastolic dysfunction (expressed by an inverted E/A ratio which represents early and late filling of the LV during atrial contraction) was present in 23 patients and in 1 control ( P < 0.001). At the end of the follow-up period, while LV systolic function declined in 1 case alone, 6 further patients developed an inverted E/A ratio. Moreover, in the group of SSc patients mean A-wave values, E/A ratio, left atrial dimension, and LV wall thickness significantly changed, all indicating the progression of heart involvement. The alteration of LV diastolic function was independent of other known causes potentially affecting LV relaxation. Moreover, impairment of LV filling parameters was detected in the first phase of follow-up, while the anatomical changes occurred in the last phase.
Our data confirm the significant prevalence of LV diastolic dysfunction in SSc patients and the role of primary myocardial involvement. The long-term follow-up demonstrates that LV filling dysfunction is progressive and precedes the occurrence of LV remodeling.

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Keywords

1 case
 
45 normal subjects
 
77 unselected SSc patients
 
atrial contraction
 
cardiac alterations
 
dysfunction
 
first clinical observation
 
first phase
 
follow-up period
 
heart involvement
 
inverted E/A ratio
 
last phase
 
long-term follow-up
 
LV diastolic dysfunction
 
LV diastolic function
 
LV relaxation
 
LV systolic function
 
LV wall thickness
 
primary myocardial involvement
 
significant prevalence