Yilmazer B, Sahin T, Cefle A
Acta Reumatol Port. 2016 Apr-Jun;41(2):131-7.
We aimed to evaluate left ventricular (LV) mechanics of patients diagnosed with PsA and no clinical evidence for cardiovascular disease (CVD) using a novel, more sensitive technique which evaluates myocardial deformation in multidimensional planes for the detection of impaired LV function.
The study enrolled 31 PsA patients and sex-age matched 19 healthy controls. All participants underwent conventional echocardiography and 2-dimensional speckle tracking echocardiography (STE). Global longitudinal, circumferential, and radial strain were measured.
Although patients with PsA had normal LV ejection fraction, the myocardial deformation in multidimensional planes was impaired. STE analysis results showed that PsA patients had significantly lower global longitudinal strain (mean±S.D. -17.11±2.83 % and -19.29±2 % respectively, p=0.005), global circumferential strain (mean±S.D. -14.28±3 % and -20.34±4.78 % respectively p<0.001) and global radial strain (mean±S.D. 29.26±10 % and 46.54±17 % respectively, p<0.001) versus control group. However, no correlation was found between longitudinal, radial, and circumferential strains and disease-related risk factors.
Subclinical impaired myocardial deformation was common in patients with PsA even with no clinical evidence for CVD. Thus, the use of this novel imaging technique could provide additional benefits for determining cardiovascular involvement at an early stage and risk stratification in PsA patients.
我们旨在使用一种新型的、更敏感的技术评估被诊断为银屑病关节炎（PsA）且无心血管疾病（CVD）临床证据的患者的左心室（LV）力学，该技术可在多维度平面评估心肌变形以检测左心室功能受损情况。
该研究纳入了31例PsA患者以及年龄和性别匹配的19名健康对照者。所有参与者均接受了常规超声心动图检查和二维斑点追踪超声心动图（STE）检查。测量了整体纵向、圆周和径向应变。
尽管PsA患者的左心室射血分数正常，但多维度平面的心肌变形受损。STE分析结果显示，与对照组相比，PsA患者的整体纵向应变（均值±标准差分别为-17.11±2.83%和-19.29±2%，p=0.005）、整体圆周应变（均值±标准差分别为-14.28±3%和-20.34±4.78%，p<0.001）和整体径向应变（均值±标准差分别为29.26±10%和46.54±17%，p<0.001）显著更低。然而，纵向、径向和圆周应变与疾病相关危险因素之间未发现相关性。
即使没有CVD的临床证据，PsA患者中也常见亚临床心肌变形受损。因此，使用这种新型成像技术可为早期确定PsA患者的心血管受累情况和风险分层提供额外的益处。
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