Associations Between Left Ventricular Myocardial Involvement and Endothelial Dysfunction in Systemic Sclerosis: Noninvasive Assessment in Asymptomatic Patients

D’Andrea, Antonello; Stisi, S.; Caso, Pio; Uccio, Fortunato Scotto di; Bellissimo, S.; Salerno, Gemma; Scarafile, Raffaella; Riegler, Lucia; Cuomo, Sergio; Citro, Rodolfo; Scherillo, Marino; Calabrò, Raffaele

doi:10.1111/j.1540-8175.2007.00436.x

Cited by 28 publications

(14 citation statements)

References 26 publications

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“…[24] This is consistent with other studies where strain imaging has been shown to be useful in the early detection of myocardial involvement in asymptomatic patients with diabetes, systemic sclerosis, amyloidosis, and doxorubicin-induced cardiomyopathy. [25262728] CMR strain and strain rate imaging may be a more sensitive indicator of myocardial involvement also in Kawasaki disease patients, both in the acute and convalescent phases. To our knowledge, this is the first study to apply CMR-FT in Kawasaki disease patients.…”

Section: Discussionmentioning

confidence: 99%

Cardiac magnetic resonance feature tracking in Kawasaki disease convalescence

Bratis

Hachmann

Child

et al. 2017

Annals of Pediatric Cardiology

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Objective:The objective of this study was to determine whether left ventricular (LV) myocardial deformation indices can detect subclinical abnormalities in Kawasaki disease convalescence. We hypothesized that subclinical myocardial abnormalities due to inflammation represent an early manifestation of the disease that persists in convalescence.Background:Myocardial inflammation has been described as a global finding in the acute phase of Kawasaki disease. Despite normal systolic function by routine functional measurements, reduced longitudinal strain and strain rate have been detected by echocardiography in the acute phase.Methods and Results:Peak systolic LV myocardial longitudinal, radial, and circumferential strain and strain rate were examined in 29 Kawasaki disease convalescent patients (15 males; mean [standard deviation] age: 11 [6.6] years; median interval from disease onset: 5.8 [5.4] years) and 10 healthy volunteers (5 males; mean age: 14 [3.8] years) with the use of cardiac magnetic resonance (CMR) feature tracking. Routine indices of LV systolic function were normal in both groups. Comparisons were made between normal controls and (i) the entire Kawasaki disease group, (ii) Kawasaki disease subgroup divided by coronary artery involvement. Average longitudinal and circumferential strain at all levels was lower in patients compared to normal controls. In subgroup analysis, both Kawasaki disease patients with and without a history of coronary involvement had similar longitudinal and circumferential strain at all levels and lower when compared to controls. There were lower circumferential and longitudinal values in Kawasaki disease patients with persisting coronary artery lesions when compared to those with regressed ones.Conclusion:In this CMR study in Kawasaki disease convalescent patients with preserved routine functional indices, we detected lower circumferential and longitudinal strain values compared to normal controls, irrespective of the coronary artery status.

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Section: Discussionmentioning

confidence: 99%

Cardiac magnetic resonance feature tracking in Kawasaki disease convalescence

Bratis

Hachmann

Child

et al. 2017

Annals of Pediatric Cardiology

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“…Along with multiple reports of RV abnormalities in SSc, usually secondary to vascular and interstitial lung disease resulting into pulmonary hypertension [19,20], a primary LV involvement related to organic and functional alterations of microvasculature, including reduced coronary flow reserve, has been observed [21-24]; in support of these data, studies performed using single photon emission computerized tomography (SPECT) have shown multiple ventricular perfusion defects in the absence of coronary artery disease documented by angiography, particularly in patients with pulmonary hypertension [25,26]. Owing to this vasculopathy, a “patchy” myocardial fibrosis develops, with a distribution unrelated to coronary vessels territories [27-30], leading, as consequences, to multiple LV diastolic and systolic abnormalities including lower TDI velocities and impaired myocardial deformation [31,32].…”

Section: Discussionmentioning

confidence: 99%

Role of 2D strain in the early identification of left ventricular dysfunction and in the risk stratification of systemic sclerosis patients

Piccione

Zito

Bagnato

et al. 2013

Cardiovasc Ultrasound

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BackgroundSystemic sclerosis (SSc) is an autoimmune chronic disease characterized by diffuse fibrosis involving several organs, including heart. Aim of our study was to analyze left ventricular (LV) myocardial deformation, by use of 2D strain, in asymptomatic SSc patients with normal LV ejection fraction.MethodsWe enrolled 29 SSc patients (28 female, 65±4 years) and 30 controls (23 female, 64±2 years). Echocardiographic study with tissue Doppler imaging (TDI) and 2D strain analysis was performed; moreover, patients were submitted to a two-year follow-up for the occurrence of cardiovascular events.ResultsStandard echocardiographic parameters and TDI velocities were comparable between groups. LV longitudinal (LS) and circumferential (CS) strains were lower in patients than in controls (−13.1±4.8 vs −22.6±4.1, p < 0.001; -15.3±6.2 vs −20.4±5.6, p = 0.001), whereas radial strain (RS) was comparable between groups; moreover, a significant correlation of LS and CS with serum levels of Scl-70 antibodies was found (r = 0.74, p = 0.001; r = 0.53, p = 0.025). In addition, patients with cardiovascular events during follow-up showed a greater impairment of LS and CS (−10.3±2.5 vs −14.4±4.1, p = 0.015; -14.2±3.1 vs −20.1±1.6, p = 0.048) and higher values of Scl-70 antibodies serum levels (p = 0.047).ConclusionThe impairment of LV function, often subclinical, worsens prognosis of SSc patients, leading to increased risk of cardiovascular complications. 2D strain, allowing the early detection of LV abnormalities and the identification of patients at greater cardiovascular risk, may be a useful tool in order to provide a more accurate management of SSc patients.

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“…Assessment of myocardial strain and SR has been used to identify early systolic impairment in arterial hypertension [89], asymptomatic mitral regurgitation [90], pulmonary hypertension [91], rejection after HTX [92], congenital cardiac abnormalities [93], obesity [94], subclinical atherosclerosis [95], and in a number of systemic diseases [96,97]. Strain can discriminate between hypertensive cardiomyopathy and nonobstructive hypertrophic cardiomyopathy [98].…”

Section: Clinical Applicationsmentioning

confidence: 99%

Echocardiography in the assessment of left ventricular longitudinal systolic function: current methodology and clinical applications

et al. 2009

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Quantification of left ventricular (LV) systolic function represents a major aspect of echocardiographic assessment in the spectrum of cardiac diseases. However, because of the high complexity of LV contraction mechanics, the classical approach with assessment of a single measure of systolic function, such as ejection fraction or fractional shortening, has been largely superseded. During the last years, through the considerable technical advances in the field of ultrasonography, a number of different echocardiographic methodologies have become available to perform a detailed assessment of different aspects of LV contraction. In particular, evaluation of LV longitudinal systolic dynamics has progressively gained importance as a key aspect in the assessment of LV systolic function. For most of the techniques currently used to explore LV longitudinal function, the clinical usefulness in both research and daily practice has been validated by consistent evidence and their use is rapidly increasing. Technical considerations and potential clinical applications of the assessment of LV longitudinal systolic function are reviewed.

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Associations Between Left Ventricular Myocardial Involvement and Endothelial Dysfunction in Systemic Sclerosis: Noninvasive Assessment in Asymptomatic Patients

Cited by 28 publications

References 26 publications

Cardiac magnetic resonance feature tracking in Kawasaki disease convalescence

Cardiac magnetic resonance feature tracking in Kawasaki disease convalescence

Role of 2D strain in the early identification of left ventricular dysfunction and in the risk stratification of systemic sclerosis patients

Echocardiography in the assessment of left ventricular longitudinal systolic function: current methodology and clinical applications

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