Which factors impact myocardial function in systemic sclerosis?

Area of Science:

• Cardiology
• Rheumatology
• Medical Imaging

Background:

• Systemic sclerosis (SSc) can affect cardiac function, particularly diastolic function of the left and right ventricles.
• Early detection of myocardial involvement is crucial for managing SSc patients.

Purpose of the Study:

• To identify clinical and echocardiographic parameters influencing left (LV) and right ventricular (RV) diastolic and global function in SSc patients.
• To establish noninvasive markers for early myocardial involvement in SSc.

Main Methods:

• Studied 50 SSc patients and 48 healthy controls using clinical examination, serology, pulmonary function tests, and echocardiography (including tissue Doppler).
• Assessed diastolic function via E/e' ratios and global function using the Tei index.
• Calculated pulmonary vascular resistance (PVR) using echocardiographic data.

Main Results:

• SSc patients showed impaired diastolic function (decreased E/A and e'/a' ratios, increased E/e') and elevated RV Tei index and PVR compared to controls.
• Multivariate analysis identified brain natriuretic peptide (BNP), DLCO, RV systolic pressure, and PVR as independent predictors of RV diastolic function and Tei index.
• BNP, DLCO, and PVR were also independently associated with LV diastolic function and Tei index.

Conclusions:

• BNP, DLCO, and PVR are valuable noninvasive parameters for assessing early myocardial involvement in SSc.
• These markers can aid in routine clinical practice for timely diagnosis and management of cardiac complications in SSc.