Systemic sclerosis (SSc) is a rare connective tissue disease that can lead to severe heart complications, i.e. congestive heart failure, arrhythmia and sudden cardiac death. SSc can be also associated with pulmonary arterial hypertension. The latter are associated with poor prognosis in SSc, may be related to a specific myocardial right ventricular disease. The aim of this study was to test whether infra-clinical myocardial dysfunction can be detected in patients with SSc free from cardiovascular symptoms.
Patients and methods .– Segmental right ventricular (RV) strain and left ventricular (LV) strain by the global longitudinal strain (GLS) were quantified by 2 Dimensional speckle-tracking with transthoracic echocardiography to assess ventricular deformations in 48 patients suffering from SSc and 40 matched control subjects.
Results .– Despite normal LVEF, patients presenting SSc had significantly impaired LV GLS compared to controls. There was only a trend for an impaired lateral and inferior RV strain between patients and controls ( P = 0.08 and 0.07 respectively). Patients with diffuse cutaneous SSc (DcSSc) had impaired LV strain in 4 and 2 chamber views and lateral RV strain compared to those presenting a limited form of cutaneous SSc (LcSSc). These differences were irrespective of the pulmonary function and the presence or not of a pulmonary hypertension (data not shown).
Subclinical cardiac injury in systemic sclerosis assessed by speckle tracking strain analysis.
Conclusion .– Speckle-tracking strain analysis can detect infra-clinical impairment of LV myocardial function in patients with SSc who are free from any cardiovascular symptoms regardless of SSc impact on pulmonary function.
