Myocardial contractility is early affected in systemic sclerosis: A Tissue Doppler echocardiography study

Meune, Christophe; Allanore, Yannick; Pascal, Olivier; Devaux, Jean-Yves; Dessault, Odile; Duboc, Denis; Weber, Simon; Kahan, André

doi:10.1016/j.euje.2004.12.006

Cited by 55 publications

(23 citation statements)

References 22 publications

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“…Although cut-offs for normal values have been refined [28], the prevalence of LV/RV impairment we report is consistent with our previous results as well as others [4,[30][31][32]. Theoretically, the right ventricle (RV) might be affected early in the course of the disease as it might be involved in both primary myocardial involvement and/or lung vascular or lung interstitial disease.…”

Section: Discussionsupporting

confidence: 94%

A right ventricular diastolic impairment is common in systemic sclerosis and is associated with other target-organ damage

Meune

Khanna

Aboulhosn

et al. 2016

Seminars in Arthritis and Rheumatism

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Section: Discussionsupporting

confidence: 94%

A right ventricular diastolic impairment is common in systemic sclerosis and is associated with other target-organ damage

Meune

Khanna

Aboulhosn

et al. 2016

Seminars in Arthritis and Rheumatism

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“…Age-related changes in cardiac responses to high pressure loads (20) may explain some of the apparent differences in RV contractility between IPAH and SSc-PAH, but direct myocardial involvement from SSc due to microvascular disease or fibrosis may also be a contributing factor. A high prevalence of early RV dysfunction has been observed in patients with SSc without PAH as determined by endomyocardial biopsy (23), magnetic resonance imaging (24)(25)(26)(27), and tissue-Doppler echocardiography (28)(29)(30)(31)(32), although the presence of PH induced by exercise was evidenced in one of the studies (29).…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic Predictors of Survival in Scleroderma-related Pulmonary Arterial Hypertension

Campo

Mathai²,

Pavec

et al. 2010

Am J Respir Crit Care Med

212

183

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Rationale: Pulmonary arterial hypertension (PAH) related to systemic sclerosis (SSc) has a poorer prognosis compared with other forms of PAH for reasons that remain unexplained. Objectives: To identify risk factors of mortality in a well-characterized cohort of patients with PAH related to systemic sclerosis (SSc-PAH). Methods: Seventy-six consecutive patients with SSc (64 women and 12 men; mean age 61 6 11 yr) were diagnosed with PAH by heart catheterization in a single center, starting in January 2000, and followed over time. Kaplan-Meier estimates were calculated and mortality risk factors were analyzed. Measurements and Main Results: Forty (53%) patients were in World Health Organization functional class III or IV. Mean pulmonary artery pressure was 41 6 11 mm Hg, pulmonary vascular resistance (PVR) was 8.6 6 5.6 Wood units, and cardiac index was 2.4 6 0.7 L/min/m 2 . Median follow-up time was 36 months, with 42 deaths observed. Survival estimates were 85%, 72%, 67%, 50%, and 36% at 1, 2, 3, 4, and 5 years, respectively. Multivariate analysis identified PVR (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.03-1.18; P , 0.01), stroke volume index (HR, 0.94; 95% CI, 0.89-0.99; P 5 0.02), and pulmonary arterial capacitance (HR, 0.43; 95% CI, 0.20-0.91; P 5 0.03) as strong predictors of survival. An estimated glomerular filtration rate less than 60 ml/min/1.73 m 2 portended a threefold risk of mortality. Conclusions: Our results suggest that specific components of right ventricular dysfunction and renal impairment contribute to increased mortality in SSc-PAH. Understanding the mechanisms of right ventricular dysfunction in response to increased afterload should lead to improved targeted therapy in these patients.

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“…In these patients with pre-capillary PH, no signs pointing to a left ventricular dysfunction (due to a specific inflammatory myocarditis and/or a proximal coronaropathy) were reported. This myocardial involvement could therefore be related to an involvement of the cardiac microvasculature leading to a worse cardiac adaptation to PH (as reported in SSc [30]). …”

Section: Figurementioning

confidence: 99%

Pulmonary hypertension in antisynthetase syndrome: prevalence, aetiology and survival

et al. 2013

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Antisynthetase syndrome is characterised by the association of interstitial lung disease and myositis with different anti-tRNA-synthetase antibodies. The occurrence, aetiology and prognosis of pulmonary hypertension have not yet been evaluated.Among 203 consecutive patients, transthoracic echocardiogram and right heart catheterisation results were retrospectively analysed in the light of clinico-biological, morphological and functional parameters. Definitions of pulmonary hypertension were based on the European Society of Cardiology/European Respiratory Society 2009 guidelines, with severe pulmonary hypertension being defined by a mean pulmonary arterial pressure .35 mmHg.Pulmonary hypertension was suspected by transthoracic echocardiogram in 47 (23.2%) cases, corresponding to pulmonary hypertension ''possible'' (n527, 13.3%) or ''likely'' (n520, 9.9%). Right heart catheterisation was performed in 21 patients, excluding pulmonary hypertension in five and confirming pre-capillary pulmonary hypertension in 16 (7.9%). Although related to interstitial lung disease in all cases, pre-capillary pulmonary hypertension was severe in 13 (81.3%) patients (mean¡SD pulmonary arterial pressure 46¡9 mmHg), frequently associated with low cardiac index (mean¡SD 2.3¡0.8 L?min -1 ?m -2 ) and high forced vital capacity/diffusing capacity of the lung for carbon monoxide ratio (2.5¡0.6). Pulmonary hypertension was significantly associated with a lower survival rate (p,0.001), with a 3-year survival rate of 58%.The occurrence of pulmonary hypertension in antisynthetase syndrome is significant and dramatically worsens the prognosis. Although systematically associated with interstitial lung disease, pulmonary hypertension was usually severe, suggesting a specific pulmonary vascular involvement. @ERSpublications PH in antisynthetase syndrome significantly worsens the prognosis, suggesting a specific pulmonary vascular involvement

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Myocardial contractility is early affected in systemic sclerosis: A Tissue Doppler echocardiography study

Abstract: Frequent abnormal myocardial perfusion is confirmed in SSc patients. Reduced contractility is also frequent as detected by TDE, despite normal radionuclide LVEF.

Cited by 55 publications

References 22 publications

A right ventricular diastolic impairment is common in systemic sclerosis and is associated with other target-organ damage

A right ventricular diastolic impairment is common in systemic sclerosis and is associated with other target-organ damage

Hemodynamic Predictors of Survival in Scleroderma-related Pulmonary Arterial Hypertension

Pulmonary hypertension in antisynthetase syndrome: prevalence, aetiology and survival

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