A right ventricular diastolic impairment is common in systemic sclerosis and is associated with other target-organ damage
| Autor: | Yannick Allanore, Jérôme Avouac, Dinesh Khanna, André Kahan, Jamil Aboulhosn, Daniel E. Furst, Christophe Meune |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Hypertension Pulmonary Ventricular Dysfunction Right Diastole 030204 cardiovascular system & hematology Contractility 03 medical and health sciences 0302 clinical medicine Rheumatology DLCO Internal medicine medicine.artery medicine Humans Aged 030203 arthritis & rheumatology Scleroderma Systemic Lung Vascular disease business.industry Heart Middle Aged medicine.disease Pulmonary hypertension Echocardiography Doppler Anesthesiology and Pain Medicine medicine.anatomical_structure Ventricle Pulmonary artery Cardiology Female business |
| Zdroj: | Seminars in Arthritis and Rheumatism. 45:439-445 |
| ISSN: | 0049-0172 |
| DOI: | 10.1016/j.semarthrit.2015.07.002 |
| Popis: | Heart involvement in systemic sclerosis (SSc) is a strong prognostic factor. Our aim was to examine left ventricle (LV) and right ventricle (RV) involvement.We examined LV and RV, systolic and diastolic functions, using echocardiography and Tissue-Doppler echocardiography (TDE) indexes, in a cohort of 212 consecutive SSc patients seen during a 9-month period at 2 institutions (Paris, France and Los Angeles, USA). They were compared to 50 healthy controls.When compared to controls, SSc patients had consistently impaired RV indices that include reduced RV contractility (p0.001), larger right atrial area (p = 0.027) and overall RV diastolic dysfunction (25% of SSc patients versus 0% of controls; p0.001). Patients also exhibited alterations in LV contractility and diastolic function (p0.001 each). In multivariate analysis, RV contractility as expressed by the TDE S(T) parameter was associated with TDE LV contractility S(M) (p = 0.030), DLCO (p = 0.013) whereas RV diastolic impairment was associated with systolic pulmonary artery pressure (p = 0.015). A subgroup of 27 patients had proven pulmonary arterial hypertension (PAH); comparison between SSc-PAH versus SSc free of PAH patients revealed reduced LV diastolic function (transmitral E/A ratio, p = 0.045 and E(A)10 cm/s, p = 0.029), reduced overall RV contractility (21.5% versus 4.5%; p = 0.03) and reduced RV diastolic function (transtricuspid E/A ratio; p = 0.014 and 68% versus 29% with impaired function; p = 0.001).Our data show that RV is commonly affected in SSc with predominant impaired diastolic function. Several factors, including primary heart, lung vascular disease and pulmonary hypertension, contribute to such impairment. |
| Databáze: | OpenAIRE |
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