Giunta A, Tirri E, Maione S, Cangianiello S, Mele A, De Luca A, Valentini G
Department of Internal Medicine, Geriatrics, Cardiovascular Pathology and Cardiac Surgery, University of Federico II, Naples, Italy.
Ann Rheum Dis. 2000 Feb;59(2):94-8. doi: 10.1136/ard.59.2.94.
To investigate right ventricular diastolic function in systemic sclerosis (SSc) and its relation to clinical features of the disease.
Seventy seven unselected SSc patients and 33 healthy subjects were submitted to echocardiography and echo Doppler study to assess left and right systolic as well diastolic function and to estimate maximal arterial systolic pulmonary pressure (PAP). In addition, the patients were investigated to define the SSc subset and the extent of skin and internal organ involvement.
An abnormal right ventricular filling, as expressed by an inverted tricuspidal (Tr) E/A ratio (Tr E/A ratio <1), was detected in 31 of the 77 SSc patients (40%) and in 0 of the 36 controls ( p<0.001 ). All the 31 patients with an inverted Tr E/A ratio were found to have a PAP > 30 mm Hg. Twenty resulted to have an inverted mitral (Mit) E/A ratio (Mit E/A ratio <1), indicating an abnormal left ventricular filling. In multiple regression analysis, Tr E/A ratio resulted to be independently correlated to both PAP (r= -0.35;p<0. 003) and Mit E/A ratio (r=0.39;p<0.001).
This study points out an impaired right ventricular filling in a significant percentage of SSc patients whatever the subset. This alteration is independently correlated to both PAP and left ventricular filling abnormalities.
研究系统性硬化症（SSc）患者的右心室舒张功能及其与疾病临床特征的关系。
对77例未经选择的SSc患者和33名健康受试者进行超声心动图和超声多普勒研究，以评估左、右心室的收缩和舒张功能，并估算最大动脉收缩期肺动脉压（PAP）。此外，对患者进行检查以确定SSc亚型以及皮肤和内脏器官受累程度。
77例SSc患者中有31例（40%）检测到右心室充盈异常，表现为三尖瓣（Tr）E/A比值倒置（Tr E/A比值<1），而36名对照组患者中无一例出现这种情况（p<0.001）。所有31例Tr E/A比值倒置的患者PAP均>30 mmHg。20例患者出现二尖瓣（Mit）E/A比值倒置（Mit E/A比值<1），表明左心室充盈异常。在多元回归分析中，Tr E/A比值与PAP（r=-0.35；p<0.003）和Mit E/A比值（r=0.39；p<0.001）均独立相关。
本研究指出，无论亚型如何，相当比例的SSc患者存在右心室充盈受损。这种改变与PAP和左心室充盈异常均独立相关。
