Ciçek Omer F, Bayram Nihal A, Ayhan Hüseyin, Erten Sükran, Aslan Abdullah N, Sarı Cenk, Ozen Mehmet B, Bİlen Emine, Bastuğ Serdal, Durmaz Tahir, Keleş Telat, Bozkurt Engin
Department of Cardiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Int J Rheum Dis. 2014 Jul;17(6):658-63. doi: 10.1111/1756-185X.12258. Epub 2013 Dec 14.
Capable of multi-organ involvement in Sjogren's syndrome (SS), cardiac findings of pulmonary effusion, left ventricular diastolic dysfunction and pulmonary hypertension are seen in patients with SS. Aortic stiffness (AS) reflects the mechanical tension and elasticity of the aorta. In this study, our aim is to determine if there is any differences in AS and left ventricular function between patients diagnosed as SS and healthy control groups.
We enrolled 50 patients with SS and 47 healthy volunteers with similar demographic characteristics. It was found that isovolumetric relaxation time (IVRT) and deceleration time (DT) were significantly longer and early diastolic wave (E) was significantly lower in patients with SS, but there was no difference in the other parameters. When tissue Doppler echocardiography (TDE) findings were compared between the two groups, it was found that myocardial systolic wave (Sm), myocardial early diastolic wave (Em) and Em/Am ratio were significantly lower, and myocardial isovolumetric relaxation time (IVRTm) and myocardial performance index (MPI) values were significantly higher in patients with SS. A significant positive correlations between aortic strain and Sm (r = 0.35, P < 0.001), Em (r = 0.42, P < 0.001) and Em/Am (r = 0.26, P = 0.008) and negative correlations in IVRTm (r = -0.36, P < 0.001) and MPI (r = -0.24, P = 0.01) were detected. A significant positive correlation between aortic distensibility and Sm (r = 0.36, P < 0.001), Em (r = 0.44, P < 0.001), Em/Am (r = 0.26, P = 0.009) and negative correlation of IVRTm (r = -0.22, P = 0.02) were determined.
There is a significant relationship between AS and left ventricular diastolic dysfunction in patients with SS in this study. The parameters of aortic elasticity measured by 2D echocardiographic methods can be beneficial in predicting early cardiovascular risk in SS.
干燥综合征（SS）可累及多器官，SS患者可见胸腔积液、左心室舒张功能障碍和肺动脉高压等心脏表现。主动脉僵硬度（AS）反映主动脉的机械张力和弹性。在本研究中，我们的目的是确定诊断为SS的患者与健康对照组之间在AS和左心室功能方面是否存在差异。
我们纳入了50例SS患者和47例具有相似人口统计学特征的健康志愿者。发现SS患者的等容舒张时间（IVRT）和减速时间（DT）显著延长，舒张早期波（E）显著降低，但其他参数无差异。比较两组的组织多普勒超声心动图（TDE）结果时，发现SS患者的心肌收缩波（Sm）、心肌舒张早期波（Em）和Em/Am比值显著降低，心肌等容舒张时间（IVRTm）和心肌性能指数（MPI）值显著升高。检测到主动脉应变与Sm（r = 0.35，P < 0.001）、Em（r = 0.42，P < 0.001）和Em/Am（r = 0.26，P = 0.008）呈显著正相关，与IVRTm（r = -0.36，P < 0.001）和MPI（r = -0.24，P = 0.01）呈负相关。确定主动脉扩张性与Sm（r = 0.36，P < 0.001）、Em（r = 0.44，P < 0.001）、Em/Am（r = 0.26，P = 0.009）呈显著正相关，与IVRTm（r = -0.22，P = 0.02）呈负相关。
本研究中SS患者的AS与左心室舒张功能障碍之间存在显著关系。二维超声心动图方法测量的主动脉弹性参数有助于预测SS患者早期心血管风险。
