Tissue Doppler assessment of right ventricular function in female patients with limited form of systemic sclerosis

Abstract

Background: Cardiac involvement in systemic sclerosis (SSc) is often clinically occult. The aim of this study was the evaluation of early subclinical right ventricular (RV) involvement in patients with limited form of systemic sclerosis by tissue Doppler. Methods: Twenty female patients with limited cutaneous SSc and 20 control female subjects, matched for age were studied with transthoracic echocardiography and tissue Doppler imaging (TDI) to assess RV function. Patients with pulmonary hypertension, chronic renal failure, diabetes mellitus, hypertension, heart failure, left ventricular hypertrophy, ischemic or rheumatic heart disease were excluded. Results: Patients with limited form SSc had significant lower tricuspid annulus peak systolic velocities (ST) (9.95 ± 1.78 vs. 11.05 ± 1.53 cm/s, p < 0.044), early (ET) (9.65 ± 1.30 vs. 12.50 ± 1.23 cm/s, p < 0.0001), late (AT) diastolic velocity (12.60 ± 2.01 vs. 18.15 ± 1.81 cm/s, p < 0.0001), and tricuspid annular plane systolic excursion (TAPSE) (23.05 ± 3.50 vs. 26.50 ± 1.90, p < 0.001) compared to controls. Myocardial performance index (MPI) of the RV was higher in SSc patients compared to controls (0.41 ± 0.05 vs. 0.30 ± 0.02, p < 0.0001). There were significant correlations between disease duration and ST and RV MPI (r = −0.883, p < 0.0001; r = 0.686, p < 0.001, respectively). Conclusions: Patients with limited form of SSc present with pulsed-tissue Doppler imaging indices indicative of right ventricle dysfunction, which had significant correlations with disease duration. Tissue Doppler is a valuable non-invasive tool for detecting RV myocardial involvement in patients with limited SSc.

Keywords

• Systemic sclerosis
• Right ventricle
• Tissue Doppler imaging