Sharifkazemi Mohammadbagher, Nazarinia Mohammadali, Arjangzade Alireza, Goldust Mohamad, Hooshanginezhad Zahra
Department of Cardiology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz 7193613311, Iran.
Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz 7193613311, Iran.
Biology (Basel). 2022 Feb 14;11(2):305. doi: 10.3390/biology11020305.
: Cardiac involvement is a predictor of poor prognosis in patients with systemic sclerosis (SSc); therefore, preclinical diagnosis of heart involvement is crucial. Two-dimensional speckle tracking echocardiography (2D-STE), a method for evaluating the myocardial strain, could be helpful for the early diagnosis of cardiac mechanical function abnormalities. In this study, the simultaneous evaluation of all cardiac chambers was studied in patients with SSc, compared with normal individuals. The results of transthoracic echocardiography (TTE) and 2D-STE of 37 patients with SSc and 37 healthy individuals and the longitudinal strain (LS) of all chambers was precisely evaluated. The collected data were analyzed using SPSS version 16, and independent-sample test and Chi-square test were used for comparison between the groups. The mean ± SD of the participants' age was 45.7 ± 11.54 (range of 17 to 68) years; most of them were women (75.7%). TTE showed higher left atrial (LA) volume ( < 0.001), right atrial (RA) area ( = 0.007), the severity of ventricular dysfunction ( < 0.05) and inferior vena cava diameter ( = 0.005), compared with the control group. Spectral and tissue Doppler echocardiography showed higher systolic pulmonary arterial pressure (sPAP) and mitral A wave velocity, and lower E/A ratio, E' velocity of left ventricular (LV) septal and lateral wall in the case group ( < 0.05). Color Doppler echocardiography showed a higher frequency of valvular regurgitation in the case group ( < 0.05). The results of 2D-STE showed lower LA roof LS ( < 0.001), LA average LS ( = 0.015), LA global LS ( = 0.028), and LA ejection fraction (LAEF) ( = 0.001), lower mean RA left wall ( = 0.048) and EF ( < 0.001), and higher RV global LS in the case group ( = 0.025). Simultaneous evaluation of all cardiac chambers by 2D-STE provides valuable information about the myocardial involvement in patients with SSc. Therefore, it is suggested to use this method for the early diagnosis of cardiac involvement in such patients.
心脏受累是系统性硬化症（SSc）患者预后不良的一个预测指标；因此，心脏受累的临床前诊断至关重要。二维斑点追踪超声心动图（2D-STE）是一种评估心肌应变的方法，可能有助于早期诊断心脏机械功能异常。在本研究中，对SSc患者的所有心腔进行了同步评估，并与正常个体进行了比较。精确评估了37例SSc患者和37例健康个体的经胸超声心动图（TTE）和2D-STE结果以及所有心腔的纵向应变（LS）。使用SPSS 16版对收集的数据进行分析，采用独立样本检验和卡方检验进行组间比较。参与者的平均年龄±标准差为45.7±11.54（17至68岁）；其中大多数为女性（75.7%）。与对照组相比，TTE显示左心房（LA）容积更高（<0.001）、右心房（RA）面积更大（=0.007）、心室功能障碍的严重程度更高（<0.05）以及下腔静脉直径更大（=0.005）。频谱和组织多普勒超声心动图显示病例组的收缩期肺动脉压（sPAP）和二尖瓣A波速度更高，左心室（LV）室间隔和侧壁的E/A比值、E'速度更低（<0.05）。彩色多普勒超声心动图显示病例组瓣膜反流的频率更高（<0.05）。2D-STE结果显示病例组的左心房顶部LS更低（<0.001）、左心房平均LS更低（=0.015）、左心房整体LS更低（=0.028）以及左心房射血分数（LAEF）更低（=0.001），右心房平均左壁更低（=0.048）和射血分数更低（<0.001），右心室整体LS更高（=0.025）。通过2D-STE对所有心腔进行同步评估可提供有关SSc患者心肌受累的有价值信息。因此，建议使用该方法对这类患者的心脏受累进行早期诊断。
