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Evaluation of cardiac structures and function in systemic sclerosis by Doppler echocardiography
S Maione1, G Valentini, A Giunta
1Istituto di I Clinica Medica, II Facoltà di Medicina, Università di Napoli-Federico II, Italia.
Insights
Doppler echocardiography revealed abnormal diastolic filling in 9 systemic sclerosis patients, indicating potential early myocardial fibrosis. These findings occurred without systolic dysfunction or other apparent heart conditions.
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Systemic sclerosis is a connective tissue disease that can affect multiple organs, including the heart.
- Cardiac involvement in systemic sclerosis can manifest as diastolic dysfunction, even in the absence of overt symptoms or other cardiac abnormalities.
Purpose of the Study:
- To investigate ventricular diastolic filling patterns in patients with systemic sclerosis using Doppler echocardiography.
- To identify early signs of cardiac involvement, specifically diastolic dysfunction, in systemic sclerosis patients.
Main Methods:
- Doppler echocardiography was performed on 51 consecutive patients with systemic sclerosis.
- Key diastolic parameters were measured: peak early (E) and late (A) diastolic flow velocities, E/A ratio, early diastolic slope, and isovolumic relaxation period.
Main Results:
- Nine out of 51 patients (17.6%) exhibited abnormal ventricular diastolic filling dynamics.
- These abnormalities were present despite the absence of left ventricular systolic dysfunction, systemic hypertension, left ventricular hypertrophy, or other clinically evident myocardial disease.
Conclusions:
- Abnormal diastolic filling patterns can be an early, isolated manifestation of myocardial fibrosis in systemic sclerosis.
- Doppler echocardiography is valuable for detecting subclinical cardiac involvement in systemic sclerosis patients.
Abstract:
Ventricular diastolic filling was investigated in a series of 51 consecutive patients with systemic sclerosis by means of Doppler echocardiography. Peak flow velocity in early (peak E) and late (peak A) diastole, E/A ratio, slope of the early diastolic flow velocity and isovolumic relaxation period were calculated. Nine out of the 51 patients showed abnormalities of ventricular filling dynamics in the absence of left ventricular systolic dysfunction at rest and after provocation. The abnormal diastolic filling pattern in these patients was detected in spite of the absence of systemic hypertension, left ventricular hypertrophy or other clinically evident myocardial disease. These diastolic abnormalities might represent an isolated evidence of the underlying myocardial fibrosis not yet clinically apparent.