Systolic and diastolic function in patients with systemic sclerosis

Background: Clinical and epidemiological findings indicate that symptomatic heart disease in patients with systemic sclerosis (SSc) predicts poor prognosis, but cardiac involvement may occur years before clinical manifestation. The aim of this study was to evaluate the cardiac function in patients with SSc and to correlate the echocardiographic parameters with others that quantify the diseases' severity. Methods: Twenty consecutive patients with SSc were investigated with transthoracic echocardiography (TTE). Two dimensional, pulsed Doppler and pulsed tissue Doppler imaging (TDI) techniques were used, in all the patients, to assess the systolic and diastolic function for left ventricle (LV). Correlations were made between echocardiographic measurements and some clinical and serological features of the patients. Results: None of the patients had any clinical signs of cardiac involvement, nor ECG or TTE systolic function impairment; there are significant differences between systemic sclerosis patients and control group for peak A velocity (0.75 +/- 0.22 vs 0.57 +/- 0.32, P=0.05), E/A ratio (1.14 +/- 0.22 vs 1.48 +/- 0.26, P=0.01), E/Ea ratio (8.25 +/- 1.57 vs 7 +/- 2.2, P=0.05), which account for filling impairment of LV. There are also significant correlations between some other parameters, like the mean duration of Raynaud's phenomenon and E/Ea ratio (r=0.48, P<0.05). Conclusions: The analysis of SSc heart disease, mainly at a preclinical level, is important in all the cases as an asymptomatic patient may have diastolic dysfunction which can be treated and should be closely observed. (C) 2008 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.