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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
Summary
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.
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