Disturbed right ventricular diastolic function in patients with systemic sclerosis: A Doppler tissue imaging study

Per Lindqvist, Kenneth Caidahl, Grete Neuman-Andersen, Cecilia Ozolins, Solbritt Rantapää-Dahlqvist, Anders Waldenström, Elsadig Kazzam

Research output: Contribution to journalArticlepeer-review

70 Citations (Scopus)

Abstract

Background: Cardiopulmonary involvement in patients with systemic sclerosis (SSc) carries a poor prognosis, mainly due to pulmonary hypertension and right-heart failure. To date, right ventricular (RV) involvement has not been studied in detail. We therefore assessed RV function in patients with SSc and related the findings to the clinical features of the disease. Method: Twenty-six consecutive patients (21 women) with SSc (mean age, 56 ± 15 years [± SD]) and 25 healthy, age-matched control subjects (21 women) were studied. Doppler echocardiography including Doppler tissue imaging was used to evaluate cardiac function. Pulmonary function was also studied. Results: Compared with control subjects, RV free wall thickness (5.8 ± 1.7 mm vs 3.7 ± 1.1 mm, p < 0.001) and right atrial (RA) systolic area (15.9 ± 3.7 cm2 vs 13.0 ± 2.3 cm2, p < 0.01) were increased in patients with SSc, while the global early diastolic/atrial component velocity ratio was reduced (1.2 ± 0.4 vs 1.7 ± 0.6, p < 0.01). The global isovolumic relaxation time (IVRT) [64 ± 23 ms vs 39 ± 13 ms, p < 0.001] and regional IVRT (83 ± 40 ms vs 46 ± 24 ms, p < 0.001) were prolonged in patients vs control subjects, whereas the RV global filling time was reduced (454 ± 122 ms vs 548 ± 104 ms, p < 0.01). RV systolic function and pulmonary pressures at rest were similar in the two groups, but the pulmonary artery acceleration time was reduced (119 ± 34 ms vs 141 ± 29 ms, p < 0.05) in patients compared to control subjects. Left ventricular function did not differ between the two groups. Conclusion: Patients with SSc exhibit altered RV diastolic function together with an increase in RV wall thickness and RA area. These findings appear to be early markers of RV disturbance, probably in response to intermittent pulmonary arterial hypertension.

Original languageEnglish
Pages (from-to)755-763
Number of pages9
JournalChest
Volume128
Issue number2
DOIs
Publication statusPublished - Aug 2005

Keywords

  • Diastolic function
  • Doppler tissue imaging
  • Echocardiography
  • Right ventricle
  • Systemic sclerosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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