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- Title
Cardiac involvement in undifferentiated connective tissue disease at risk for systemic sclerosis (otherwise referred to as very early-early systemic sclerosis): a TDI study.
- Authors
D’Alto, Michele; Riccardi, Antonella; Argiento, Paola; Di Stefano, Ilaria; Romeo, Emanuele; Iacono, Agostino Mattera; D’Andrea, Antonello; Fasano, Serena; Sanduzzi, Alessandro; Bocchino, Marialuisa; Docimo, Ludovico; Tolone, Salvatore; Russo, Maria Giovanna; Valentini, Gabriele
- Abstract
Undifferentiated connective tissue disease at risk for systemic sclerosis (UCTD-risk-SSc), otherwise referred to as very early-early SSc, is a condition characterized by Raynaud’s phenomenon with serum SSc marker autoantibodies and/or typical capillaroscopic findings and unsatisfying classification criteria for the disease. The aim of the present study was to assess the prevalence of right (RV) or left ventricular (LV) systolic and/or diastolic dysfunction by standard echocardiography and tissue Doppler imaging (TDI). Thirty patients with UCTD-risk-SSc (28 female, mean age 47 ± 13 years, range 21-70) and 30 age- and sex-matched controls underwent cardiac assessment by standard echocardiography and TDI. UCTD-risk-SSc patients and controls did not show any difference at standard echocardiography. Despite results falling within the respective normal ranges, TDI pointed out a mild impairment of LV and RV diastolic (<italic>E</italic>m 15 ± 4 vs. 19 ± 5, <italic>p</italic> = 0.0004; <italic>E</italic>/<italic>E</italic>m 6.1 ± 1.7 vs. 4.8 ± 1.2, <italic>p</italic> = 0.001; <italic>E</italic>t 14 ± 3 vs. 16 ± 2, <italic>p</italic> = 0.02; <italic>E</italic>t/<italic>A</italic>t 0.9 ± 0.4 vs. 1.3 ± 0.3, <italic>p</italic> = 0.002; <italic>E</italic>/<italic>E</italic>t 3.5 ± 1.2 vs. 4.2 ± 0.9, <italic>p</italic> = 0.02) and systolic function (<italic>S</italic>m 13 ± 3 vs. 15 ± 2 cm/s, <italic>p</italic> < 0.0003; <italic>S</italic>t 14 ± 2 vs. 16 ± 3 cm/s, <italic>p</italic> < 0.0001) and increased estimated pulmonary artery wedge pressure (9 ± 2 vs. 8 ± 1, <italic>p</italic> = 0.001) in UCTD-risk-SSc patients as compared to controls. Notably, a statistically significant difference also emerged in the prevalence of TDI detected E′/A′t, (71% of UCTD-risk-SSc patients vs. 19% of controls; <italic>p</italic> < 0.0001). Our study shows that UCTD-risk-SSc patients show a previously unrecognized, mild biventricular systolic and diastolic dysfunction as compared to controls. The pathophysiologic meaning as well the predictive value of developing overt SSc await to be elucidated.
- Subjects
CONNECTIVE tissue diseases; SYSTEMIC scleroderma; CARDIOVASCULAR diseases risk factors; ECHOCARDIOGRAPHY; HEART ventricle diseases; SYSTOLIC blood pressure; DISEASE risk factors
- Publication
Clinical & Experimental Medicine, 2018, Vol 18, Issue 2, p237
- ISSN
1591-8890
- Publication type
Article
- DOI
10.1007/s10238-017-0477-y