Evaluation Of Ventricular Function In Patients With Systemic Sclerosis By Speckle Tracking Imaging

Objective: To evaluate left ventricular global systolic function by three-dimensional speckle tracking imaging(3D-STI) in patients with systemic sclerosis(SSc), and to determine the diagnostic value of all global strains parameters in detecting cardiac function damage of SSc.Methods: A total of 34 patients with SSc were enrolled,16 patients with limited cutaneous SSc(lc SSc),18 with diffuse cutaneous SSc(dc SSc). For comparison, 22 matched healthy control subjects were included. After collecting full-volume image of apical four-chamber,the software was applied to acquire the data including left ventricular global area peak systolic strain(GAS),global circumferential peak systolic strain(GCS),global longitudinal peak systolic strain(GLS),global radial peak systolic strain(GRS) and left ventricular ejection fraction(LVEF),etc. The global strain values to diagnose cardic function damage were analyzed by the receiver operating characteristic(ROC) curve.Results: Compared with controls, GAS,GCS,GLS and GRS in patients with SSc had significantly decreased(-26.3±3.3%,-16.7±2.9%,-15.9±2.6%,40.7±8.3% vs-31.1±2.8%,-18.5±2.5%,-19.2±1.8%, 46.4±10.3% respectively,all P <0.05). Patients with dc SSc showed worse values in GAS and GLS, as compared to patients with lc SSc(-25.1±3.3%,-15.0±2.4% vs-27.6±2.9%,-16.8±2.6% respectively, both P <0.05). ROC curve shows that the area under the curve(AUC) of GAS to diagnose cardic function damage is largest,that was 0.877. The cutoff value,the sensitivity and specificity were-20.34%, 88.2% and 77.3%,respectively.Conclusions: The longitudinal,circumferential and radial systolic function have damaged to varying degrees in patients with SSc. 3D-STI analysis can detect subtle left ventricular global systolic dysfunction. GAS has the highest accuracy among the four global strain parameters. Objective: To evaluate right ventricular function by two-dimensional speckle tracking imaging(2D-STI) in patients with systemic sclerosis(SSc).Methods: A total of 34 patients with SSc were enrolled,18 patients with diffuse cutaneous SSc(dc SSc), 16 with limited cutaneous SSc(lc SSc). For comparison, 22 matched healthy control subjects were included. All subjects underwent transthoracic echocardiography. Right ventricular free wall global longitudinal peak systolic strain(GLS)and systolic,early and late diastolic strain rate(GLSRs 、 GLSRe 、 GLSRa) were measured by 2D-STI respectively.Every parameter was compared.The correlations between GLS and pulmonary arterial systolic pressure(PASP),disease duration in patients with SSc were analysed.Results: ①Compared with controls, GLS, GLSRs and GLSRe in patients with SSc had significantly decreased(all P <0.05). Patients with dc SSc showed worse values in GLS and GLSRe(all P <0.05), as compared with lc SSc. ②GLS was inversely correlated with PASP and disease duration(r=-0.447,P=0.008 and r=-0.500,P=0.003,respectively).Conclusions: Right ventricular systolic and diastolic functions have damaged in patients with SSc. Patients with dc SSc show worse functions as compared to patients with lc SSc. 2D-STI analysis can be used accurately to assess the right ventricular function.GLS is moderately correlated with PASP and disease duration.