Speckle tracking echocardiography in systemic sclerosis: A useful method for detection of myocardial involvement

Ann Cardiol Angeiol (Paris). 2019 Oct;68(4):226-231. doi: 10.1016/j.ancard.2018.08.027. Epub 2018 Oct 2.

Abstract

Background: Systemic sclerosis is a multisystem disorder characterized by tissue fibrosis and organ damage. Heart involvement is one of the main factors shortening survival, which may be underestimated by conventional echocardiography measurements. Two-dimensional speckle-tracking echocardiography is a powerful novel modality to assess subclinical myocardial dysfunction.

Aim: The aim of this study is to investigate heart involvement in systemic sclerosis patients, and to determine the usefulness of ventricular longitudinal deformation using the Two-dimensional speckle tracking technology for an early detection of ventricular dysfunction.

Patients and methods: Between May 2016 and September 2016, 25 patients with systemic sclerosis and 25 healthy subjects underwent echocardiography to assess heart abnormalities and the strain of the two ventricles using two dimensions' speckle tracking echography.

Results: The two groups were comparable in age and gender. Despite comparable left ventricle systolic function (left ventricular ejection fraction patients 64.58±8.87 vs. in healthy 68.2±7.41, P=0.19), patients presented altered longitudinal peak systolic strain values (global longitudinal strain: patients -17.42±1.62 vs. healthy -19.24±8.85, P<0.0001). Despite comparable pulmonary artery systolic pressure, there was a significant alteration in right ventricular systolic and diastolic function assessed by standard measurement. Longitudinal peak systolic strain of the right ventricle was significantly lower in patients compared with controls (P<0.01).

Conclusion: Ventricular deformation analysis by two dimensions' speckle tracking echocardiography appears to be a sensitive method to detect early ventricular impairment in patients with systemic sclerosis.

Keywords: Echocardiography; Fonction ventriculaire; Left ventricular function; Myocardial strain; Sclérodermie systémique; Strain; Échocardiographie.

MeSH terms

  • Adult
  • Aged
  • Cardiomyopathies / diagnostic imaging*
  • Cardiomyopathies / etiology*
  • Echocardiography / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Scleroderma, Systemic / complications*