Left atrial dysfunction detected by speckle tracking in patients with systemic sclerosis

Gergely Agoston, Luna Gargani, Marcelo Haertel Miglioranza, Maria Caputo, Luigi Paolo Badano, Antonella Moreo, Denisa Muraru, Sergio Mondillo, Alberto Moggi Pignone, Marco Matucci Cerinic, Rosa Sicari, Eugenio Picano, Albert Varga

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Abstract

Aim. To assess whether STE strain parameters may detect early alterations in LA function in SSc patients.

Methods. Forty-two SSc patients (Group 1, age 50 ± 14 years, 95% females) without clinical evidence for cardiac involvement and 42 age- and gender-matched control subjects (Group 2, age 49 ± 13 years, 95% females) were evaluated with comprehensive 2D and Doppler echocardiography, including tissue Doppler imaging analysis. Positive peak left atrial longitudinal strain ( pos peak), second positive left atrial longitudinal strain (sec pos peak), and negative left atrial longitudinal strain ( neg peak) were measured using a 12-segment model for the LA, by commercially available semi-automated 2D speckle-tracking software (EchoPac PC version 108.1.4, GE Healthcare, Horten, Norway).

Results: All SSc patients had a normal left ventricular ejection fraction (63.1 ± 4%). SSc patients did not differ from controls in E/A (Group 1 = 1.1 ± 0.4 vs Group 2 = 1.3 ± 0.4, p =.14) or pulmonary arterial systolic pressure (Group 1 = 24.1 ± 8 mmHg vs Group 2 = 21 ± 7 mmHg, p =.17). SSc patients did not show significantly different indexed LA volumes (Group 1 = 24.9 ± 5.3 ml/m2 vs Group 2 = 24.7 ± 4.4 ml/m2, p =.8), whereas E/e' ratio was significantly higher in SSc (Group 1 = 7.6 ± 2.4 vs Group 2 = 6.5 ± 1.7, p<0.05), although still within normal values. LA strain values were significantly different between the two groups ( pos peak Group 1 = 31.3 ± 4.2% vs Group 2 = 35.0 ± 7.6%, p <.01, sec pos peak Group 1 = 18.4 ± 4 vs Group 2 = 21.4 ± 7.6, p < 0.05).

Conclusion: 2D speckle-tracking echocardiography is a sensitive tool to assess impairment of LA mechanics, which is detectable in absence of changes in LA size and volume, and may represent an early sign of cardiac involvement in patients with SSc.

Background: Cardiac involvement is a relevant clinical finding in systemic sclerosis (SSc) and is associated with poor prognosis. Left atrial (LA) remodeling and/or dysfunction can be an early sign of diastolic dysfunction. Two-dimensional speckle tracking echocardiography (STE) is a novel and promising tool for detecting very early changes in LA myocardial performance.

Original languageEnglish
Article number30
JournalCardiovascular Ultrasound
Volume12
Issue number1
DOIs
Publication statusPublished - Aug 5 2014

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Agoston, G., Gargani, L., Miglioranza, M. H., Caputo, M., Badano, L. P., Moreo, A., Muraru, D., Mondillo, S., Moggi Pignone, A., Matucci Cerinic, M., Sicari, R., Picano, E., & Varga, A. (2014). Left atrial dysfunction detected by speckle tracking in patients with systemic sclerosis. Cardiovascular Ultrasound, 12(1), [30]. https://doi.org/10.1186/1476-7120-12-30