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Subclinical Cardiac Dysfunction in Polymyositis and Dermatomyositis: A Speckle-tracking Case-control Study
Federico Guerra1,2, Chiara Gelardi1,2, Alessandro Capucci1,2
1From the Cardiology and Arrhythmology Clinic, and the Clinical Medicine, Clinical and Molecular Sciences Department, Marche Polytechnic University, University Hospital "Ospedali Riuniti," Ancona, Italy.
The Journal of Rheumatology
|April 3, 2017
Summary
Global longitudinal strain (GLS) detects subclinical systolic dysfunction in idiopathic inflammatory myopathies (IIM) patients. This cardiac imaging technique is valuable for identifying early heart issues in IIM, even without apparent left ventricular dysfunction.
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Subclinical heart disease affects up to 50% of patients with idiopathic inflammatory myopathies (IIM).
- Conventional imaging often fails to detect early systolic ventricular dysfunction in IIM patients.
- Idiopathic inflammatory myopathies (IIM) are a group of rare autoimmune diseases affecting muscles.
Purpose of the Study:
- To evaluate the utility of global longitudinal strain (GLS) measurement for detecting subclinical systolic ventricular dysfunction in IIM patients.
- To compare GLS between IIM patients and healthy controls.
- To explore correlations between GLS and disease characteristics.
Main Methods:
- 28 IIM patients and 28 matched controls were enrolled.
- Standard echocardiographic variables and speckle-tracking global longitudinal strain (GLS) of the left ventricle (LV) and right ventricle (RV) were measured.
- Correlations between GLS and muscle strength, disease activity, cardiovascular risk factors, and organ involvement were assessed.
Main Results:
- GLS was significantly reduced in IIM patients compared to controls for both LV (-18.7% vs -21.2%) and RV (-19.3% vs -22.5%).
- IIM patients had a significantly increased risk of impaired LV GLS (RR 4.9) and RV GLS (RR 3.4).
- Reduced GLS was not associated with muscle strength, disease activity, or other clinical factors.
Conclusions:
- Subclinical systolic impairment is prevalent in IIM patients, even without overt left ventricular dysfunction.
- Global longitudinal strain (GLS) is a sensitive imaging biomarker for detecting early cardiac involvement in IIM.
- GLS measurement offers a valuable tool for identifying subclinical ventricular dysfunction in IIM.