Echocardiographic alterations in systemic sclerosis: A longitudinal study

Stefania Maione, Giovanna Cuomo, Anna Giunta, Laura Tanturri De Horatio, Giovanni La Montagna, Francesco Manguso, Ivo Alagia, Gabriele Valentini

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To investigate the evolution of cardiac alterations in systemic sclerosis (SSc). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Original languageEnglish
Pages (from-to)721-727
Number of pages7
JournalSeminars in Arthritis and Rheumatism
Volume34
Issue number5
DOIs
Publication statusPublished - Apr 2005

Keywords

  • Echocardiography
  • Left ventricular filling
  • Longitudinal study
  • Systemic sclerosis

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Orthopedics and Sports Medicine
  • Rheumatology

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