Magda Ștefania Lucia, Gheorghiu Ana Maria, Mincu Raluca Ileana, Ciobanu Andrea Olivia, Constantinescu Tudor, Popa Elisa Cristina, Mihai Carina, Vinereanu Dragoș
Department of Cardiology and Cardiovascular Surgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Cardiology and Cardiovascular Surgery, University and Emergency Hospital, 050098 Bucharest, Romania.
Medicina (Kaunas). 2024 Dec 19;60(12):2080. doi: 10.3390/medicina60122080.
: Systemic sclerosis (SSc) causes myocardial and microvascular impairment, with subclinical dysfunction and eventually permanent cardio-vascular damage. The long-term influence of SSc therapies on subclinical cardiovascular dysfunction is insufficiently investigated. We aimed to assess 2D and 4D cardiac ultrasound parameters of heart function in patients with different forms of SSc versus controls and to determine the evolution of cardiac function and arterial stiffness parameters under therapy. : A total of 60 subjects with SSc were studied at baseline; 30 SSc patients were compared to 30 matched controls. A total of 52 SSc subjects were reassessed after 1 year and 30 after 2 years of treatment. Cardiac function was evaluated through 2D standard echocardiography, tissue Doppler, speckle tracking and 4D auto LV quantification echo. Arterial stiffness was determined via the cardio-ankle vascular index and ankle brachial index. : At baseline, the standard echo parameters were normal. The 4D and myocardial work parameters, although in normal limits, were significantly altered in the SSc group vs. controls (4D ejection fraction 54.5 ± 8.5% in SSc vs. 63.8 ± 3.1% in controls; 4D longitudinal strain -14.2 ± 2.4% in SSc vs. -22.0 ± 2.7% in controls; global constructive work 2124.2 ± 449.5 mmHg% in SSc vs. 3102.8 ± 337.5 mmHg% in controls, for all ≤ 0.02). Both at 1 year and 2 years of treatment, all echo and arterial stiffness parameters were similar to baseline, with no correlation to treatment type. : SSc determines subclinical systolic dysfunction. Non-invasive assessment methods do not detect a functional cardiovascular decline in patients on classical therapy. Complex cardiac follow-up should be implemented in cases at risk for complications.
系统性硬化症（SSc）可导致心肌和微血管损伤，出现亚临床功能障碍并最终造成永久性心血管损害。SSc治疗对亚临床心血管功能障碍的长期影响尚未得到充分研究。我们旨在评估不同类型SSc患者与对照组患者心脏功能的二维和四维心脏超声参数，并确定治疗期间心脏功能和动脉僵硬度参数的变化情况。：共60例SSc患者在基线期接受研究；30例SSc患者与30例匹配的对照组进行比较。共有52例SSc受试者在治疗1年后重新评估，30例在治疗2年后重新评估。通过二维标准超声心动图、组织多普勒、斑点追踪和四维自动左心室定量超声评估心脏功能。通过心踝血管指数和踝臂指数测定动脉僵硬度。：在基线期，标准超声心动图参数正常。尽管四维和心肌做功参数在正常范围内，但SSc组与对照组相比有显著改变（SSc组四维射血分数为54.5±8.5%，对照组为63.8±3.1%；SSc组四维纵向应变-14.2±2.4%，对照组为-22.0±2.7%；整体建设性做功SSc组为2124.2±449.5 mmHg%，对照组为3102.8±337.5 mmHg%，所有P≤0.02）。在治疗1年和2年时，所有超声心动图和动脉僵硬度参数均与基线期相似，且与治疗类型无关。：SSc可导致亚临床收缩功能障碍。非侵入性评估方法未检测到接受传统治疗的患者心血管功能下降。对于有并发症风险的病例，应进行复杂的心脏随访。
