Author/Authors :
Rezai Yazdi، Zahra نويسنده Rheumatic Disease Research Center, Mashhad University of
Medical Sciences, Mashhad, IR Iran , , Fazlinezhad، Afsoon نويسنده , , Bigdelu، Leila نويسنده Cardiovascular Research Center, Mashhad University of Medical Science, Mashhad, Iran. , , Alizadeh-Sani، Fariba نويسنده Mashhad University of Medical Sciences, Mashhad, IR Iran , , Tabatabaei Yazdi، Golsa نويسنده Mashhad University of Medical Sciences, Mashhad, IR
Iran , , Izanloo، Azra نويسنده Msc in Medical Education, Department of Radiology Technology, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran. ,
Abstract :
Pulmonary arterial hypertension (PAH) is a leading cause of death
in systemic sclerosis (SSc) patients. Early detection of systolic
failure in SSc patients will facilitate early treatment and improve the
survival rate of these patients. In this study, besides studying the RV
function in SSC patients, attempts have been made to find a new possible
noninvasive echocardiographic test for early diagnosis of systolic
failure as a PAH complication. 30 patients with at least a 2-year
history of diffuse SSc confirmed by an expert rheumatologist were
enrolled in this study. All the patients underwent transthoracic
echocardiography by an echocardiologist. Fractional area change (FAC) of
the right ventricle (RV), tricuspid annular plane systolic excursion
(TAPSE), RV lateral wall strain and strain rate (Base, Mid, Apex),
RV-EDD and RV pressure with respect to inferior vena cava (IVC) diameter
as well as Left Ventricle’s Ejection Fraction (LVEF) were evaluated. The
prevalence rate of PAH was reported 36.6% in this study. There was no
significant relationship between LVEF and RV parameters. LVEF was found
to be significantly higher in women whereas RV strain turned out to be
higher in men. Besides, there was a significant relation between
pulmonary arterial pressure (PAP) and Basal (P = 0.03), mid RV strain (P
= 0.002), RV strain rate (P = 0.001) and RV diameter (P = 0.02). Also,
an inverse relation was observed between RV systolic (P = 0.01) and
diastolic functions (P = 0.007) with PAP. In addition, no significant
relationship was found between LVEF and body mass index (BMI) and RV
parameters (P > 0.05). Moreover, Apical RV strain and LVEF were
found to be higher in males and females respectively. Furthermore, a
significant relationship was found between RV strain and age (P =
0.027). Finally, the results did not show any relationship between RV
systolic and diastolic functions and gender. This paper states the
likely advantages of strain and strain rate echocardiography in
identifying patients with more diffused and severe SSc and the need for
further longitudinal studies based on the mentioned method for early
diagnosis of myocardial impairment.
