Background. Scleroderma is an autoimmune disease that can affect left and right heart function directly through inflammation and fibrosis and indirectly through systemic and pulmonary arterial hypertension. Pulmonary hypertension related to scleroderma is associated with high morbidity and mortality as well as poorer response to therapy. The introduction of Tissue Doppler Imaging (TDI) and Strain Rate Imaging (SRI) techniques have made possible a more adequate assessment of global and regional systolic and diastolic right ventricular function. Our purpose was: 1) to compare TDI/SRI parameters with conventional echocardiographic indices evaluating right ventricular function; 2) to assess the correlation among TDI/SRI parameters and pulmonary artery pressure. Methods . Twenty-seven patients with scleroderma were studied. 14 patients had pulmonary artery pressure >35mmHg (group I), 13 patients had pulmonary artery pressure <35mmHg (group II). Fifteen healthy subjects who had normal cardiac findings served as controls (group III). Right ventricular ejection fraction (EF), fractional shortening (FS), and tricuspid flow filling parameters (E/A ratio, DT) were determined. Offline analysis of the myocardial velocity data sets was performed using dedicated software. Velocity and strain traces from right ventricular free wall at 3 levels (basal, mid cavity, and apical) were processed from the same wall site in the apical 4-chamber view. Systolic (Sw) and diastolic (Ew, Aw) TDI values, peak systolic strain and systolic and diastolic strain rate values were determined. Results. Ew/Aw ratio at basal and mid level was lower in Group I and II than in Group III (p<0.005). No significant difference in Ew/Aw ratios was shown between Group I and II. Peak systolic strain and systolic and diastolic strain rate at basal and mid level were lower in Group I than in Group II (p<0.005) and in Group I and II compared to Group III (p<0.001). Right ventricular EF, FS, E/A ratio, and DT were not different among the three groups. No correlation was found between EF, FS, E/A ratio, DT, and pulmonary artery pressure. A significant correlation was also obtained between peak systolic strain rate at basal FW site and pulmonary artery systolic pressure (r=0.69, p<0.005). Conclusion. In scleroderma patients TDI/SRI parameters can determine right ventricular dysfunction that is not shown by conventional echocardiographic indices and is correlated with pulmonary artery pressure

Assessment of right ventricular dysfunction by strain Doppler echocardiography in patients with scleroderma / Vitarelli, Antonino; Conde, Y; D'Orazio, Simona; Cimino, E; Stellato, Simona; Padella, V; Battaglia, Daniela; Caranci, Fiorella; Salsano, Felice. - In: EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY. - ISSN 1525-2167. - STAMPA. - (2007). (Intervento presentato al convegno Euroecho 11 tenutosi a Lisbon, Portugal nel 5-8 Dec. 2007).

Assessment of right ventricular dysfunction by strain Doppler echocardiography in patients with scleroderma

VITARELLI, Antonino;D'ORAZIO, SIMONA;STELLATO, SIMONA;BATTAGLIA, DANIELA;CARANCI, FIORELLA;SALSANO, Felice
2007

Abstract

Background. Scleroderma is an autoimmune disease that can affect left and right heart function directly through inflammation and fibrosis and indirectly through systemic and pulmonary arterial hypertension. Pulmonary hypertension related to scleroderma is associated with high morbidity and mortality as well as poorer response to therapy. The introduction of Tissue Doppler Imaging (TDI) and Strain Rate Imaging (SRI) techniques have made possible a more adequate assessment of global and regional systolic and diastolic right ventricular function. Our purpose was: 1) to compare TDI/SRI parameters with conventional echocardiographic indices evaluating right ventricular function; 2) to assess the correlation among TDI/SRI parameters and pulmonary artery pressure. Methods . Twenty-seven patients with scleroderma were studied. 14 patients had pulmonary artery pressure >35mmHg (group I), 13 patients had pulmonary artery pressure <35mmHg (group II). Fifteen healthy subjects who had normal cardiac findings served as controls (group III). Right ventricular ejection fraction (EF), fractional shortening (FS), and tricuspid flow filling parameters (E/A ratio, DT) were determined. Offline analysis of the myocardial velocity data sets was performed using dedicated software. Velocity and strain traces from right ventricular free wall at 3 levels (basal, mid cavity, and apical) were processed from the same wall site in the apical 4-chamber view. Systolic (Sw) and diastolic (Ew, Aw) TDI values, peak systolic strain and systolic and diastolic strain rate values were determined. Results. Ew/Aw ratio at basal and mid level was lower in Group I and II than in Group III (p<0.005). No significant difference in Ew/Aw ratios was shown between Group I and II. Peak systolic strain and systolic and diastolic strain rate at basal and mid level were lower in Group I than in Group II (p<0.005) and in Group I and II compared to Group III (p<0.001). Right ventricular EF, FS, E/A ratio, and DT were not different among the three groups. No correlation was found between EF, FS, E/A ratio, DT, and pulmonary artery pressure. A significant correlation was also obtained between peak systolic strain rate at basal FW site and pulmonary artery systolic pressure (r=0.69, p<0.005). Conclusion. In scleroderma patients TDI/SRI parameters can determine right ventricular dysfunction that is not shown by conventional echocardiographic indices and is correlated with pulmonary artery pressure
2007
Euroecho 11
-
04 Pubblicazione in atti di convegno::04c Atto di convegno in rivista
Assessment of right ventricular dysfunction by strain Doppler echocardiography in patients with scleroderma / Vitarelli, Antonino; Conde, Y; D'Orazio, Simona; Cimino, E; Stellato, Simona; Padella, V; Battaglia, Daniela; Caranci, Fiorella; Salsano, Felice. - In: EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY. - ISSN 1525-2167. - STAMPA. - (2007). (Intervento presentato al convegno Euroecho 11 tenutosi a Lisbon, Portugal nel 5-8 Dec. 2007).
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/193053
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