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Assessing Blood pressure using a doppler ultrasound01:19

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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
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Tissue Doppler imaging in systemic sclerosis: a 3-year longitudinal study.

Michele D'Alto1, Giovanna Cuomo2, Emanuele Romeo1

  • 1Department of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.

Seminars in Arthritis and Rheumatism
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PubMed
Summary

Systemic sclerosis (SSc) patients show impaired biventricular function and increased pulmonary artery pressure, worsening over three years. Cardiac dysfunction in SSc does not correlate with treatment.

Keywords:
Pulmonary artery systolic pressureSystemic sclerosisTissue Doppler imagingVentricular function

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Area of Science:

  • Cardiology
  • Rheumatology
  • Medical Imaging

Background:

  • Systemic sclerosis (SSc) is a complex autoimmune disease affecting multiple organs, including the heart.
  • Cardiac involvement in SSc can lead to significant morbidity and mortality, often presenting as biventricular dysfunction.
  • Early detection and monitoring of cardiac disease in SSc are crucial for patient management.

Purpose of the Study:

  • To evaluate the progression of cardiac disease in patients with Systemic Sclerosis (SSc) using echocardiography and tissue Doppler imaging (TDI).
  • To correlate cardiac dysfunction with clinical, serological, and treatment factors in SSc patients.
  • To assess changes in cardiac function over a 3-year follow-up period.

Main Methods:

  • Standard echocardiography and pulsed-tissue Doppler imaging (TDI) were used for cardiac assessment.
  • 74 SSc patients and 71 controls underwent cardiac evaluation at baseline and a 3-year follow-up.
  • Data analysis included comparisons between groups and multiple regression to identify associated factors.

Main Results:

  • At baseline, SSc patients exhibited impaired left (LV) and right ventricular (RV) diastolic and systolic function, and higher pulmonary artery systolic pressure (sPAP) compared to controls.
  • A 3-year follow-up revealed further deterioration of biventricular function and increased sPAP in SSc patients.
  • Diastolic dysfunction (Em/Am < 1, Et/At < 1) was associated with age, NYHA class, capillaroscopic pattern, and cardiac Medsger score; TDI abnormalities correlated with cardiac Medsger score. Treatment did not correlate with cardiac function changes.

Conclusions:

  • SSc patients consistently demonstrate biventricular systolic and diastolic dysfunction, along with elevated sPAP.
  • These cardiac abnormalities progressively worsen over a 3-year period in SSc patients.
  • Cardiac dysfunction in SSc is linked to disease severity and clinical features but not drug treatment.