Unique Abnormalities in Right Ventricular Longitudinal Strain in Systemic Sclerosis Patients

Area of Science:

• Cardiology
• Rheumatology
• Medical Imaging

Background:

• Cardiac involvement in systemic sclerosis (SSc) significantly impacts prognosis.
• Conventional echocardiography and clinical exams often fail to detect early cardiac dysfunction in SSc patients.
• Right ventricle (RV) function is crucial but often overlooked in SSc monitoring.

Purpose of the Study:

• To investigate the utility of speckle-derived strain for detecting subclinical RV abnormalities in SSc patients.
• To compare RV contractility using speckle-derived strain between SSc patients and healthy controls.
• To identify occult myocardial disease in the RV of SSc patients.

Main Methods:

• Echocardiography with speckle-tracking strain analysis was performed on 138 SSc patients and 40 controls.
• Standard RV function parameters (TAPSE, FAC) were measured.
• RV longitudinal systolic strain was assessed globally and regionally (base, mid, apex).

Main Results:

• Tricuspid annular plane systolic excursion (TAPSE) did not differ between groups.
• Fractional area change (FAC) was lower in SSc patients but remained within normal limits.
• Speckle-derived strain revealed significant global and regional RV dysfunction in SSc patients, with decreased strain in the apex and mid-segments and increased strain in the base, a pattern not detected by conventional measures.

Conclusions:

• Speckle-derived strain imaging identifies a heterogeneous pattern of regional RV strain in SSc.
• This pattern suggests occult RV myocardial disease in SSc patients.
• Speckle-derived strain is a sensitive tool for detecting early RV abnormalities in SSc, surpassing conventional echocardiographic methods.