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Deformation analysis of the right ventricle using speckle tracking in the diagnosis of pulmonary arterial hypertension in patients with systemic sclerosis and mixed connective tissue disease


Authors: J. Vymětal 1;  M. Hutyra 2;  A. Smržová 1;  M. Skácelová 1;  Z. Heřmanová 3;  K. Langová 4 ;  P. Horák 1
Authors place of work: 3. interní klinika – nefrologická, revmatologická a endokrinologická, LF UP a FN Olomouc 1;  1. interní klinika – kardiologická, LF UP a FN Olomouc 2;  Oddělení imunologie, LF UP a FN Olomouc 3;  Oddělení biostatistiky, LF UP Olomouc 4
Published in the journal: Čes. Revmatol., 23, 2015, No. 4, p. 123-132.
Category: Original Papers

Summary

Pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) is serious and life prognosis influencing organ complication. Its early non-invasive detection is based on regular screening echocardiography. The aim of this study is to assess the contribution of right ventricle longitudinal strain (RVLS) performed by speckle tracking echocardiography in PAH diagnostics.

Cohort and Methods:
Total 74 patients (60 patients with systemic sclerosis and 14 patients with mixed connective tissue disease) was examined by echocardiography; Besides routine left and right ventricle (RV) function assessment and pulmonary pressure estimation, the fractional area change (RV-FAC) of the right ventricle and 2D strain of right ventricle free wall were evaluated. Concurrently, levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), Troponin T, characteristic auto antibodies and diffuse lung capacity for carbon monoxide (DLCO) were measured. Patients with probable pulmonary hypertension underwent right heart catheterization (RHC).

Results:
Pulmonary hypertension (PH) was unlikely in 59 patients (79.7 %), possible in 10 patients (13.5 %) and probable in 5 patient (6.7 %). A significant correlation was found for pulmonary artery systolic pressure (PASP) and RV free wall global longitudinal, resp. middle segment strain (r = 0.292, p = 0.012), for PASP and NT-proBNP (r = 0,436 p = 0.001) and further for PASP and RV-FAC (r = 0.320, p 0.005). The pulmonary artery systolic pressure did not correlate with left ventricle systolic or diastolic functions parameters in this cohort.

Conclusion:
Right ventricle strain measurement can be an useful complement in patients with systemic sclerosis and pulmonary hypertension.

Key words:
scleroderma, mixed connective tissue disease, echocardiography, speckle tracking


Zdroje

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Štítky
Dermatology & STDs Paediatric rheumatology Rheumatology
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