Left ventricular global longitudinal strain is impaired in systemic sclerosis and shows a significant correlation with the functional capacity of the patients
█ Original article
Vértes Vivien1, Nógrádi Ágnes1, Porpáczy Adél1, Minier Tünde2, Czirják László2, Komócsi András1, Faludi Réka1
Pécsi Tudományegyetem, Klinikai Központ,
2Reumatológiai és Immunológiai Klinika, Pécs
Introduction: The subclinical myocardial involvement is common in systemic sclerosis (SSc) and is associated with poor prognosis. 2D-speckle-tracking-derived global longitudinal strain (GLS) is a reliable tool to detect the subclinical impairment of the left ventricular (LV) function. Our aim was to investigate if LV GLS shows any correlation with the clinical and echocardiographic data as well as with the functional status and quality of life of the patients in SSc.
Patients, methods: 72 SSc patients (58.6±10.1 years, 66 female) were investigated. Their results were compared with the data of 23 gender- and age-matching healthy volunteers. Exclusion criteria were: pulmonary arterial hypertension, atrial fibrillation, reduced LV ejection fraction (<55%) or significant left sided valvular disease. In addition to the standard echocardiography, loops were stored digitally for the off-line analysis of the GLS. SF-36 questionnaire was used to assess quality of life. Partial correlation analysis was used to investigate the correlations between the parameters, with age as corrective factor.
Results: In SSc patients significantly lower GLS values were found compared to healthy persons (–17.2±2.3 vs. –18.7±1.4%, p=0.001). Durations of the disease from the onset of the Raynaud phenomenon (r=0.274; p=0.021) and from the first non-Raynaud symptoms (r=0.245; p=0.039) show significant correlation with GLS. In addition, GLS values showed significant correlation with the New York Heart Association functional class of the patients (r=0.242; p=0.042) and with physical functioning component of the SF-36 survey (r=–0.250; p=0.040).
Conclusion: 2D-speckle-tracking-derived GLS is a suitable tool to detect the early, subclinical LV dysfunction in patients with SSc. GLS shows correlation with the duration of the disease, and is a significant determinant of the functional capacity and quality of life of the patients in SSc.