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Essential Hypertension Worsens Left Ventricular Contractility in Systemic Sclerosis
Valentina Mercurio1, Alicia M Hinze2, Laura K Hummers3
1V. Mercurio, MD, PhD, Assistant Professor of Medicine, University of Naples Federico II, Department of Translational Medical Sciences, and Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine.
The Journal of Rheumatology
|January 16, 2021
Summary
Systemic sclerosis (SSc) patients have reduced heart contractility, even without hypertension. Essential hypertension further worsens this subclinical cardiac dysfunction in SSc patients.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Primary cardiac involvement is common and serious in systemic sclerosis (SSc).
- The impact of traditional cardiovascular risk factors like essential hypertension (HTN) on cardiac function in SSc is not well understood.
Purpose of the Study:
- To investigate the effects of essential hypertension (HTN) on left ventricular (LV) contractility in patients with SSc.
- To utilize echocardiography-derived global longitudinal strain (GLS) to assess LV contractility.
Main Methods:
- Compared 56 SSc patients with HTN (SSc+HTN+) and 82 SSc patients without HTN (SSc+HTN-) to 40 hypertensive (SSc-HTN+) and 40 non-hypertensive (SSc-HTN-) controls.
- Assessed LV ejection fraction (LVEF), left atrial volume index (LAVI), LV diastolic function, and LV contractility via GLS.
Main Results:
- SSc patients exhibited diminished GLS compared to controls, irrespective of HTN status, despite normal LVEF.
- SSc+HTN+ patients showed the highest prevalence of diastolic dysfunction and the most significant reduction in GLS.
Conclusions:
- Subclinical LV contractile dysfunction is present in SSc, even with normal LVEF.
- Concomitant HTN exacerbates LV dysfunction and diastolic impairment in SSc patients.
- HTN is a critical, modifiable cardiovascular risk factor requiring aggressive management in SSc.
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