Echocardiographic Follow-Up of Patients With Systemic Sclerosis
Echocardiographic Follow-Up of Patients With Systemic Sclerosis
Clinical myocardial dysfunction in patients with systemic sclerosis (SSc), an entity characterized by extensive fibrosis, is recognized only in 15–25%. In histological studies, however, myocardial involvement is more common. In the myocardium, fibrosis tends to be patchy but distributed throughout the myocardium in both ventricles. Importantly, cardiac involvement is one of the leading causes of disease-related death. Fortunately, significant advances in symptomatic organ-specific therapy have been made during recent years. Consequently, preclinical identification of myocardial manifestation is highly encouraged. At present, there is a lack of longitudinal evaluations concerning the presence and development of functional myocardial abnormalities. Echocardiography with newer modalitites like 2D speckle tracking (STE) allow assessment of myocardial deformation as a sensitive marker for regional and global LV systolic function and have already been analysed in SSc patients. STE is a semi-automatic algorithm that can be carried out quickly in daily practise and is only minimally affected by inter- and intraobserver variability. Since STE uses only standard 2D images, analyses can be performed offline from even already recorded examinations. These advantages let STE appear as an attractive method particularly for serial echocardiographic examinations.
The aim of this study was to assess subclinical changes in LV function by STE in SSc patients with preserved left ventricular ejection fraction (LVEF) and without pulmonary hypertension over a duration of two years.
Background
Clinical myocardial dysfunction in patients with systemic sclerosis (SSc), an entity characterized by extensive fibrosis, is recognized only in 15–25%. In histological studies, however, myocardial involvement is more common. In the myocardium, fibrosis tends to be patchy but distributed throughout the myocardium in both ventricles. Importantly, cardiac involvement is one of the leading causes of disease-related death. Fortunately, significant advances in symptomatic organ-specific therapy have been made during recent years. Consequently, preclinical identification of myocardial manifestation is highly encouraged. At present, there is a lack of longitudinal evaluations concerning the presence and development of functional myocardial abnormalities. Echocardiography with newer modalitites like 2D speckle tracking (STE) allow assessment of myocardial deformation as a sensitive marker for regional and global LV systolic function and have already been analysed in SSc patients. STE is a semi-automatic algorithm that can be carried out quickly in daily practise and is only minimally affected by inter- and intraobserver variability. Since STE uses only standard 2D images, analyses can be performed offline from even already recorded examinations. These advantages let STE appear as an attractive method particularly for serial echocardiographic examinations.
The aim of this study was to assess subclinical changes in LV function by STE in SSc patients with preserved left ventricular ejection fraction (LVEF) and without pulmonary hypertension over a duration of two years.
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