04-35 - DOPPLER MYOCARDIAL IMAGING IN THE EVALUATION OF RIGHT VENTRICULAR FUNCTION IN SYSTEMIC SCLEROSIS: A CASE-CONTROL MATCHED STUDY - 09/04/08
Hammoudi [1],
Dr Kiet Tiev [2],
Dr Stephane Ederhy [2],
Dr Gilles Hejblum [2],
Pr Jean Cabane [2],
Pr Ariel Cohen [2]
Voir les affiliationsBackground: Cardiovascular involvement in systemic sclerosis (SSc) carries a poor prognosis mainly due to pulmonary hypertension and right ventricular (RV) failure.
Objective: The aim of our study was to investigate RV function in patients (pts) with SSc using Doppler myocardial imaging (DMI).
Methods: Using a case-control design, 24 consecutive SSc pts (mean age 52.4 ± 9.6years, 23 women) and 20 age and sex-matched healthy subjects were prospectively studied. Longitudinal strain () and strain rate (SR) measured in basal, mid and apical RV free wall (FW) segments were used to assess RV regional systolic function. Isovolumic relaxation time (IVRT) as an index of RV diastolic function was measured from pulsed DMI curve at annular tricuspid plan.
Doppler echocardiography examination included measurement of the following parameters: tricuspid regurgitation peak velocity (TRV), RV wall thickness (WT), ratio of RV diastolic diameter to left ventricular diameter (RV/LVd) and RV fractional area shortening (RVFAS).
SSc pts underwent pulmonary function testing including carbon monoxide diffusing capacity (DLCO). TRV > 2.5 m/s was used in SSc group as a threshold (TRVthresh) to define elevated RV systolic pressure. All statistical test performed were non parametric ones.
Results: The observed values of TRV, RV WT and RV/LVd in SSc pts were all above the corresponding values observed in the control group, the comparisons resulting in significant differences with p < = 0.01.
We observed 7 and 17 pts above and below TRVthresh, respectively. In these two groups of pts, corresponding values of DLCO (% theoric: 39 ± 13 and 69 ± 16), RVFAS (%: 43.8±7.8 and 54.2 ± 6.6), RV FW mid segment (%: -20.7±6.1 and -29.1 ± 5.9), RV FW mid segment SR (s?:-1.15 ± 0.5 and -1.8 ± 0.58) and RV IVRT (ms: 73 ± 79 and 9 ± 19) were significantly different. In whole study population (SSc and controls), a relatively good correlation was found between RV FW mid segment and global RV systolic function assessed by RVFAS (r = 0.56, p < 0.001).
Conclusion: Patients with SSc and elevated RV systolic pressure had decreased RV systolic deformation parameters and involvement of diastolic function. In addition, RV mid segment appears as a potential index of global RV systolic function.
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Vol 100 - N° 12
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