title: Abnormalities of left ventricular function in asymptomatic patients with systemic sclerosis using Doppler measures of myocardial strain.
abstract: OBJECTIVE
  To verify whether myocardial impairment can be detected by tissue Doppler imaging (TDI) in patients with asymptomatic systemic sclerosis (SSc), 35 patients with SSc with normal left ventricular (LV) ejection fraction and 35 control subjects were studied.
  
  
  METHODS
  Myocardial longitudinal peak systolic velocity, strain, and strain rate (SR) were measured by TDI at a regional level, and for each parameter the average value was calculated using an LV 12-segment model. In addition, the mitral annulus diastolic velocities and the E/Ea ratio were obtained. Myocardial calibrated integrated backscatter (cIB) was used as an index of fibrosis.
  
  
  RESULTS
  Compared with controls, patients with SSc showed lower peak strain (-19.5% +/- 2.3% vs -26.1% +/- 2.4%, P < .001), peak SR (-1.34 +/- 0.14 s(-1) vs -1.59 +/- 0.14 s(-1), P < .001), septal cIB (-19.5 +/- 3.1 dB vs -23.8 +/- 1.6 dB, P < .001), and posterior wall cIB (-23.4 +/- 2.9 dB vs -28.6 +/- 2.5 dB, P = .001), and higher E/Ea (11.7 +/- 2.5 vs 9.8 +/- 1.1, P < .001), whereas peak systolic velocities did not differ. Strain, SR, and E/Ea correlated better with cIB than systolic velocities.
  
  
  CONCLUSIONS
  TDI-derived strain, SR, and E/Ea can detect impairment of LV myocardial function in asymptomatic patients with SSc with normal LV ejection fraction better than TDI systolic velocities.
authors.affiliation: Azienda Ospedaliera Universitaria, Ferrara, Italy; Fondazione Salvatore Maugeri, Brescia, Italy. donatomele@libero.it
authors.forename: Donato
authors.initials: D
authors.lastname: Mele
authors.forename: Stefano
authors.initials: S
authors.lastname: Censi
authors.forename: Renato
authors.initials: R
authors.lastname: La Corte
authors.forename: Elisa
authors.initials: E
authors.lastname: Merli
authors.forename: Andrea
authors.initials: A
authors.lastname: Lo Monaco
authors.forename: Antonella
authors.initials: A
authors.lastname: Locaputo
authors.forename: Claudio
authors.initials: C
authors.lastname: Ceconi
authors.forename: Francesco
authors.initials: F
authors.lastname: Trotta
authors.forename: Roberto
authors.initials: R
authors.lastname: Ferrari
mesh_terms: D000465:Algorithms; D015150:Echocardiography, Doppler / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012595:Scleroderma, Systemic / Q000150:complications* / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*