OBJECTIVE:Cardiac involvement is the most important cause of mortality in juvenile systemic sclerosis (JSSc). Recent reports in adult patients underline that traditional techniques of imaging are inadequate to assess the subclinical cardiac involvement, while speckle tracking echocardiography (STE) is able to identify ventricular dysfunctions in the early stages. The aim of our study was to assess the role of STE in JSSc. METHODS:Demographic, clinical and laboratory data were collected from patients with JSSc. Cardiac investigations performed at baseline (T0) and 18 (T18) and 36 months (T36) follow-up included electrocardiography, conventional echocardiography with measurement of the ejection fraction (EF) and STE with assessment of left and right ventricular global longitudinal strain (LV-GLS and RV-GLS). Cardiac parameters have been compared with demographic characteristics and disease severity, assessed by the Juvenile Systemic Sclerosis Severity Score (J4S). RESULTS:A total of 18 patients, 12 (67%) females, entered the study. At T0, electrocardiography was abnormal in three patients, EF was reduced in one, LV-GLS was abnormal in three (16.7%) and RV-GLS was abnormal in five (27.8%). At T18, EF remained stable while at T36 the result decreased in seven of nine patients. At the same time, LV-GLS also worsened (from -21.6% to -18.2%, P = 0.01). LV-GLS and RV-GLS at baseline showed a significant correlation with J4S (P = 0.012 and P = 0.02, respectively). CONCLUSION:STE is more sensitive than standard echocardiography to identify cardiac involvement in JSSc. Over time, we observed a gradual worsening of LV-GLS, a sign of left ventricular dysfunction, that anticipated by several months the decrease of EF.

译文

目的:心脏受累是青少年系统性硬化症(JSSc)死亡的最重要原因。成人患者的最新报道强调,传统的成像技术不足以评估亚临床心脏受累,而散斑跟踪超声心动图(STE)能够在早期识别出心室功能障碍。我们研究的目的是评估STE在JSSc中的作用。
方法:收集JSSc患者的人口统计学,临床和实验室数据。在基线(T0),18(T18)和36个月(T36)随访时进行的心脏检查包括心电图检查,常规超声心动图检查(测量射血分数(EF))和STE(评估左心室和右心室总纵向应变(LV)) -GLS和RV-GLS)。已通过青少年系统性硬化症严重程度评分(J4S)对心脏参数与人口统计学特征和疾病严重程度进行了比较。
结果:总共18位患者,其中12位女性(67%)进入了研究。在T0时,三名患者的心电图异常,一例EF降低,三例(16.7%)的LV-GLS异常,五例(27.8%)的RV-GLS异常。在T18时,EF保持稳定,而在T36时,九名患者中的七名患者的结果下降。同时,LV-GLS也恶化了(从-21.6%降至-18.2%,P = 0.01)。基线时的LV-GLS和RV-GLS与J4S呈显着相关性(分别为P = 0.012和P = 0.02)。
结论:STE比标准超声心动图对识别JSSc的心脏受累更为敏感。随着时间的流逝,我们观察到左室功能不全的迹象LV-GLS逐渐恶化,预计几个月后EF会下降。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录