Related Experiment Video
Updated: Sep 15, 2025
04:44
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
20.2K
Cardiac function and mechanics in systemic sclerosis: a systematic review and meta-analysis
Mihnea Casian1,2,3, Alina Dima4,5, Ciprian Jurcuț6
1University of Medicine and Pharmacy "Carol Davila", Str. Dionisie Lupu 37, Sector 2, 020021, Bucharest, Romania. mihnea.casian@drd.umfcd.ro.
Echo Research and Practice
|July 13, 2025
Summary
Systemic sclerosis (SSc) significantly impairs cardiac function, affecting all chambers. This systematic review highlights reduced cardiac mechanics in SSc patients compared to controls, even without symptoms.
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Systemic sclerosis (SSc) is a connective tissue disease with potential multi-organ involvement, including the heart.
- Cardiac dysfunction in SSc can be subclinical and may precede overt symptoms.
- Echocardiography, particularly tissue Doppler imaging (TDI) and speckle-tracking echocardiography (STE), offers sensitive measures of cardiac mechanics.
Purpose of the Study:
- To systematically evaluate and compare conventional, TDI, and STE-derived cardiac parameters across all heart chambers between SSc patients and healthy controls.
- To identify specific echocardiographic markers of cardiac involvement in SSc.
- To explore differences based on SSc subtype and symptom status.
Main Methods:
- A systematic review and meta-analysis adhering to PRISMA guidelines was conducted.
- Searches of MEDLINE, Scopus, and Web of Science were performed using keywords related to speckle tracking and systemic sclerosis.
- Pooled analyses determined weighted mean differences (WMD) for various echocardiographic parameters between SSc patients and controls, with subgroup analyses conducted.
Main Results:
- The meta-analysis included 41 studies with 2497 SSc cases and 1439 controls.
- Significant differences were observed in TDI velocities (septal, lateral, tricuspid S' and e' waves) between SSc patients and controls.
- STE revealed attenuated parameters in SSc patients, including impaired left ventricular global longitudinal, circumferential, and radial strain, right ventricular strain, and atrial reservoir strain.
Conclusions:
- Systemic sclerosis is associated with significantly impaired cardiac function and mechanics compared to healthy individuals.
- These impairments are evident across all cardiac chambers and detectable even in the absence of symptoms or pulmonary hypertension.
- Echocardiographic parameters, especially STE-derived strain, are valuable in assessing cardiac involvement in SSc.
Related Concept Videos
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
36
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
36
01:17Pathophysiology of Heart Failure
1.9K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.9K
01:29Cardiomyopathy V: Interprofessional Care
37
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
37
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
54
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
54
01:29Heart Failure II: Pathophysiology
46
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
46
01:30Cardiomyopathy II: Dilated Cardiomyopathy
24
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
24