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Heart diastolic dysfunction in patients with systemic sclerosis

Michał Ciurzyński1, Piotr Bienias1, Katarzyna Irzyk1

  • 1Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland.

Archives of Medical Science : AMS
|August 7, 2014
PubMed

Insights

Systemic sclerosis (SSc) patients show impaired left and right ventricular diastolic function, which worsens over time for the left ventricle. Elevated tissue inhibitors of metalloproteinase-1 (TIMP-1) levels correlate with diastolic dysfunction in SSc.

Area of Science:

  • Cardiology
  • Rheumatology
  • Biomarkers

Background:

  • Limited data exist on ventricular diastolic function in systemic sclerosis (SSc).
  • The relationship between diastolic dysfunction and matrix remodeling biomarkers in SSc is not well-defined.

Purpose of the Study:

  • To assess left ventricular (LV) and right ventricular (RV) diastolic function in SSc patients.
  • To evaluate changes in diastolic function over time (≥1 year follow-up).
  • To investigate the association between diastolic function and serum tissue inhibitors of metalloproteinase-1 (TIMP-1) levels.

Main Methods:

  • Prospective study of 111 SSc patients and 21 controls.
  • Transthoracic echocardiography for LV and RV diastolic function assessment.
  • Serum TIMP-1 levels measured at baseline and follow-up (mean 3.0 ±1.1 years).

Main Results:

  • Impaired LV relaxation in 34% of SSc patients vs. 5% of controls (p < 0.001).
  • Lower mean E/A ratio in SSc patients, decreasing significantly after follow-up (p = 0.02).
  • Elevated serum TIMP-1 levels at follow-up correlated with echocardiographic parameters (E/E').

Conclusions:

  • LV and RV diastolic relaxation are impaired in SSc patients.
  • LV diastolic function deteriorates over time in SSc.
  • TIMP-1 serum levels are linked to LV diastolic function and matrix remodeling in SSc.
Abstract

Keywords:
biomarkersdiastolic functionechocardiographysystemic sclerosis

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