Which Factors Impact Myocardial Function in Systemic Sclerosis?

IntroductionThere are limited data on left (LV) and right ventricular (RV) diastolic function in systemic sclerosis (SSc) patients especially in relation to biomarkers of matrix remodeling. The aim of the study was to analyze LV and RV myocardial diastolic function in SSc patients at baseline and after at least 1 year of follow-up and its relation to serum tissue inhibitors of metalloproteinase 1 (TIMP-1) level.Material and methodsWe prospectively studied 111 SSc patients (101 female, 10 male, age 54.2 ±13.8 years) and 21 age-matched controls (18 female, 3 male, age 49.3 ±10.5 years). After at least 1 year of observation (3.0 ±1.1 years) we reevaluated 69 of the SSc patients. Transthoracic echocardiography (Philips, iE33) for assessment of LV and RV diastolic function was performed and TIMP-1 serum level was measured.ResultsImpaired LV relaxation was observed in 38 (34%) SSc patients and in 1 (5%) of the controls (p < 0.001). The mean E/A ratio was lower in patients with SSc than in controls (p = 0.002) and significantly decreased after the follow-up period (p = 0.02). Impaired RV relaxation was detected in 25 (22.5%) SSc patients and in 1 (5%) control subject (p < 0.001) but did not deteriorate after follow-up. Mean serum level of TIMP-1 was significantly elevated in the follow-up group compared to baseline examination (p = 0.0001). Serum TIMP-1 level correlated positively with E/E’, both septal and lateral (r = 0.4, p = 0.002 and r = 0.32, p = 0.01).ConclusionsThe LV and RV relaxation is impaired in SSc patients. Moreover, left ventricular diastolic function deteriorated after the follow-up period. The TIMP-1 serum levels correlate with echocardiographic parameters, providing a potent link for LV diastolic function and matrix remodeling in patients with SSc.

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“…Recently, Ivanovic et al . reported an increased RV Tei index in 50 SSc patients compared to controls ( p < 0.001) [30]. …”

Section: Discussionmentioning

confidence: 99%

Heart diastolic dysfunction in patients with systemic sclerosis

Ciurzyński¹,

Bienias²,

Irzyk³

et al. 2014

aoms

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Section: Discussionmentioning

confidence: 77%

“…Previous studies that investigated RV remodeling showed that RV systolic and diastolic function are significantly deteriorated in the SSc population . Their authors agreed about the negative effect of SSc on RV diastolic function assessed by Doppler imaging . On the other hand, changes in RV systolic function evaluated by different 2DE parameters were reported by some investigators, but not by others …”

Section: Discussionmentioning

confidence: 91%

“…However, arrhythmias, conduction disturbances, myocardial fibrosis, and ischemia have been shown to be associated with worse outcome in these patients . In the last two decades, SSc has been shown to lead to cardiac remodeling and to deteriorate all cardiac chambers . New imaging techniques like speckle tracking imaging and three‐dimensional echocardiography offered an insight into cardiac function and mechanics in the SSc patients comparable with that of cardiac magnetic resonance, the “gold standard” cardiac imaging modality .…”

Section: Introductionmentioning

confidence: 99%

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Systemic sclerosis impacts right heart and cardiac autonomic nervous system

Tadić

Zlatanović²,

Cuspidi

et al. 2017

J of Clinical Ultrasound

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“…However, these markers will increase in response to any myocardial damage, even in patients without PH, and they are important serological markers for cardiac lesions in general. Ivanovic et al 329 . compared 50 SSc patients with age‐matched control patients and reported that BNP predicted left ventricular diastolic dysfunction.…”

Section: Guidelines For Treatment Of the Heartmentioning

confidence: 99%

Diagnostic criteria, severity classification and guidelines of systemic sclerosis

Asano

Jinnin

Kawaguchi

et al. 2018

The Journal of Dermatology

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Several effective drugs have been identified for the treatment of systemic sclerosis (SSc). However, in advanced cases, not only their effectiveness is reduced but they may be also harmful due to their side-effects. Therefore, early diagnosis and early treatment is most important for the treatment of SSc. We established diagnostic criteria for SSc in 2003 and early diagnostic criteria for SSc in 2011, for the purpose of developing evaluation of each organ in SSc. Moreover, in November 2013, the American College of Rheumatology and the European Rheumatology Association jointly developed new diagnostic criteria for increasing their sensitivity and specificity, so we revised our diagnostic criteria and severity classification of SSc. Furthermore, we have revised the clinical guideline based on the newest evidence. In particular, the clinical guideline was established by clinical questions based on evidence-based medicine according to the New Minds Clinical Practice Guideline Creation Manual (version 1.0). We aimed to make the guideline easy to use and reliable based on the newest evidence, and to present guidance as specific as possible for various clinical problems in treatment of SSc.

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Which Factors Impact Myocardial Function in Systemic Sclerosis?

Abstract: Our study revealed some new noninvasive parameters (BNP, DLCO, and PVR), which are useful for everyday clinical practice for determining of early myocardial involvement in SSc. (Echocardiography, **;:1-11).

Cited by 13 publications

References 31 publications

Heart diastolic dysfunction in patients with systemic sclerosis

Heart diastolic dysfunction in patients with systemic sclerosis

Systemic sclerosis impacts right heart and cardiac autonomic nervous system

Diagnostic criteria, severity classification and guidelines of systemic sclerosis

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Which Factors Impact Myocardial Function in Systemic Sclerosis?

Abstract: Our study revealed some new noninvasive parameters (BNP, DLCO, and PVR), which are useful for everyday clinical practice for determining of early myocardial involvement in SSc. (Echocardiography, ****;**:1-11).

Cited by 13 publications

References 31 publications

Heart diastolic dysfunction in patients with systemic sclerosis

Heart diastolic dysfunction in patients with systemic sclerosis

Systemic sclerosis impacts right heart and cardiac autonomic nervous system

Diagnostic criteria, severity classification and guidelines of systemic sclerosis

Contact Info

Product

Resources

About

Abstract: Our study revealed some new noninvasive parameters (BNP, DLCO, and PVR), which are useful for everyday clinical practice for determining of early myocardial involvement in SSc. (Echocardiography, **;:1-11).