Cardiac dysfunction in mixed connective tissue disease: a nationwide observational study

Area of Science:

• Cardiology
• Rheumatology
• Internal Medicine

Background:

• Mixed connective tissue disease (MCTD) is a systemic autoimmune disorder with diverse clinical manifestations.
• Cardiac involvement in MCTD is not fully understood, necessitating further investigation into cardiac function in affected individuals.

Purpose of the Study:

• To assess cardiac function in patients with established MCTD using echocardiography.
• To investigate the association between cardiac dysfunction, disease activity, pulmonary involvement, and cardiovascular risk factors in MCTD patients.

Main Methods:

• A cross-sectional case-control study involving 77 MCTD patients and 59 healthy controls.
• Comprehensive assessments included transthoracic echocardiography, electrocardiogram, blood samples, and pulmonary computed tomography for patients.
• Evaluated left and right ventricular function parameters, including fractional shortening, mitral annulus plane systolic excursion (MAPSE), early diastolic velocity of the mitral annulus (e'), and tricuspid annular plane systolic excursion (TAPSE).

Main Results:

• MCTD patients exhibited subclinical left ventricular dysfunction, evidenced by lower fractional shortening, MAPSE, and e' compared to controls.
• Right ventricular dysfunction was observed in MCTD patients, indicated by reduced TAPSE.
• Cardiac dysfunction (e' and TAPSE) correlated with baseline disease activity but was independent of pulmonary disease and cardiovascular risk factors.

Conclusions:

• Echocardiographic examinations reveal a higher prevalence of cardiac dysfunction in MCTD patients compared to healthy controls.
• Cardiac dysfunction in MCTD is associated with disease activity and appears to be an integral component of the multi-organ involvement characteristic of the disease.