Prevalence and risk factors for left ventricular diastolic dysfunction in systemic sclerosis: a multi-center study of CRDC cohort in China

Systemic sclerosis is a connective tissue disease characterized by wide-spread vascular lesionsand fibrosis of the skin and internal organs. It is an immune mediated rheumatic disease with thepresence of an immunological dysfunction of T lymphocytes, especially Th1 and Th17 subtypes. Itaffects gastrointestinal, pulmonary, vascular, musculoskeletal, cardiac and various other systems.This disease is rare but has high morbidity and mortality with less known effective management. Wereport a case of 70-year-old female with systemic sclerosis presented with pain along with swellingover multiple joints since 18 months which exacerbated since last 6 months and wound over fingertips since last 2 weeks. We present here other various signs, investigations and management of thisuncommon disease systemic sclerosis, also known as scleroderma. Various systems are evident tobe involved including cardiac (left ventricular diastolic dysfunction) and peripheral vascular system(Raynaud’s phenomenon).

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Asymptomatic left ventricular diastolic dysfunction in diffuse systemic sclerosis patients: conventional echocardiography and left atrial speckle tracking

Egyptian Rheumatology and Rehabilitation ◽

10.4103/err.err_15_19 ◽

2019 ◽

Vol 46 (3) ◽

pp. 170

Author(s):

Ahmed Aboughanima ◽

Abdelaziz Gomaa ◽

Gehan El Olemy

Keyword(s):

Systemic Sclerosis ◽

Diastolic Dysfunction ◽

Left Atrial ◽

Speckle Tracking ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

Diffuse Systemic Sclerosis ◽

Ventricular Diastolic Dysfunction ◽

Conventional Echocardiography

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Left Ventricular Diastolic Dysfunction — Early Cardiac Impairment in Patients with Polymyositis/Dermatomyositis: A Tissue Doppler Imaging Study

The Journal of Rheumatology ◽

10.3899/jrheum.130044 ◽

2013 ◽

Vol 40 (9) ◽

pp. 1572-1577 ◽

Cited By ~ 13

Author(s):

Zhang Lu ◽

Qiao Wei ◽

Zu Ning ◽

Zhao Qian-Zi ◽

Shu Xiao-Ming ◽

...

Keyword(s):

Risk Factors ◽

Diastolic Dysfunction ◽

Late Onset ◽

Mitral Annulus ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

Doppler Imaging ◽

Mitral Annulus Velocity ◽

Significant Difference ◽

Ventricular Diastolic Dysfunction

Objective.To investigate early cardiac involvement in patients with polymyositis/dermatomyositis (PM/DM), and to evaluate the risk factors for early cardiac impairment.Methods.The study population included 46 patients with PM/DM who did not have overt cardiovascular manifestations and 21 age- and sex-matched healthy controls. Traditional echocardiography and tissue Doppler imaging (TDI) were used to evaluate cardiac function in both groups. Clinical characteristics were recorded. Multivariate logistics regression analysis was applied to investigate risk factors for early cardiac impairment in patients with PM/DM.Results.No significant difference was found between patients and controls by traditional echocardiography. However, compared to controls, PM/DM patients had a significantly lower ratio of early diastolic mitral annulus velocity to late diastolic mitral annulus velocity (Em/Am; 1.23 ± 0.52, 1.79 ± 0.37, respectively; t = −4.485, p < 0.001) and a higher ratio of peak early diastolic transmitral flow velocity to Em (E/Em; 8.26 ± 2.57, 6.76 ± 1.17; t = 3.287, p < 0.05) as found by TDI measurements. There was no significant difference between the TDI variables of patients with PM and DM. The multivariate regression analysis showed that female sex (OR 11.044, 95% CI 1.066–114.357, p = 0.044), late onset (OR 1.157, 95% CI 1.047–1.278, p = 0.004), and duration of disease (OR 1.060, 95% CI 1.008–1.115, p = 0.023) were risk factors for abnormal left ventricular filling pressures.Conclusion.TDI is useful for detecting early cardiac impairment in patients with PM/DM. Left ventricular diastolic dysfunction is an early feature of cardiac involvement. Female sex, late onset, and long course of disease are 3 independent risk factors for predicting left ventricular diastolic dysfunction in patients with PM/DM.

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