title: Detection of subclinical cardiac involvement in systemic sclerosis by echocardiographic strain imaging.
abstract: BACKGROUND
  Cardiac involvement is one of the major problems in systemic sclerosis (SSc). Subclinical cardiac involvement has a higher frequency than thought previously. In this study we investigated whether subclinical cardiac involvement can be detected by using echocardiographic strain imaging in SSc patients without pulmonary hypertension.
  
  
  METHODS
  Echocardiographic examinations were performed to 27 SSc patients and 26 healthy controls. Left ventricular strain parameters were obtained from apical views and average strain value was calculated from these measurements.
  
  
  RESULTS
  There were no significant differences between patients and controls regarding two-dimensional (2D), conventional Doppler and tissue Doppler velocity measurements. Strain was reduced in 6 of 12 segments of the left ventricle (LV) and in 1 of 2 segments of the right ventricle (RV). Strain rate (SR) was reduced in 2 of 12 segments of the LV and 1 of 2 segments of the RV in SSc patients as compared to controls (P < 0.05 for all). These involvements did not match any particular coronary artery distribution. More important differences were detected by average strain and SR values of the LV between patients and controls (19.78 +/- 3.00% vs 23.41 +/- 2.73%, P < 0.001; 2.01 +/- 0.41 vs 2.23 +/- 0.27/sec, P = 0.026, respectively). Furthermore, carbon monoxide diffusion capacity (DLCO) in scleroderma patients significantly correlated with LV average strain (r = 0.59; P = 0.001).
  
  
  CONCLUSIONS
  Evaluation of ventricular function by using echocardiographic strain imaging appears to be useful to detect subclinical cardiac involvement in SSc patients with normal standard echocardiographic and tissue Doppler velocity findings.
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey. alperkepez@yahoo.com
authors.forename: Alper
authors.initials: A
authors.lastname: Kepez
authors.forename: Ali
authors.initials: A
authors.lastname: Akdogan
authors.forename: L Elif
authors.initials: LE
authors.lastname: Sade
authors.forename: Ali
authors.initials: A
authors.lastname: Deniz
authors.forename: Umut
authors.initials: U
authors.lastname: Kalyoncu
authors.forename: Omer
authors.initials: O
authors.lastname: Karadag
authors.forename: Mutlu
authors.initials: M
authors.lastname: Hayran
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Ihsan
authors.initials: I
authors.lastname: Ertenli
authors.forename: Sedat
authors.initials: S
authors.lastname: Kiraz
authors.forename: Meral
authors.initials: M
authors.lastname: Calguneri
authors.forename: Giray
authors.initials: G
authors.lastname: Kabakci
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgozoglu
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000150:complications*; D018709:Statistics, Nonparametric; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*