title: Two-dimensional speckle tracking of the left ventricle in patients with systemic sclerosis for an early detection of myocardial involvement.
abstract: OBJECTIVE
  Myocardial involvement is associated with poor prognosis in patients with systemic sclerosis (SSc). Two-dimensional speckle-tracking echocardiography (STE) is a powerful novel modality for the assessment of subclinical cardiac left ventricular (LV) dysfunction that, so far, has not been investigated in SSc patients. The aim of this study was to evaluate deformation analyses derived from STE for early detection of LV systolic dysfunction in patients with SSc having preserved left ventricular ejection fraction (LVEF).
  
  
  RESULTS
  Twenty-two patients with SSc (57.1 ± 13.3 years, LVEF 64 ± 3.1%, mean time of 5.4 ± 4.6 years from diagnosis) and 22 gender- and age-matched healthy subjects (57.4 ± 14.0 years, LVEF 65 ± 2.7%) underwent echocardiography with STE to assess global and regional LV function. The global longitudinal 2D peak systolic strain (PSS) of the left ventricle was significantly lower in the SSc group compared with controls: -19.0 ± 2.4 vs. -21.1 ± 2.5% (P = 0.008). This was mainly driven by a reduced strain in the basal segments. Strain in the medial segments and in the apex did not differ significantly. In addition, there was a significant difference between both groups regarding the global longitudinal PSS rate of the left ventricle (-1.19 ± 0.18 vs. -1.43 ± 0.26 s(-1), P = 0.001).
  
  
  CONCLUSIONS
  LV deformation analysis by STE is a sensitive method to detect early LV systolic impairment primarily in the basal segments in patients with SSc having preserved LVEF.
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Campus Mitte, Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin D-10117, Germany. sebastian.spethmann@charite.de
authors.forename: Sebastian
authors.initials: S
authors.lastname: Spethmann
authors.forename: Henryk
authors.initials: H
authors.lastname: Dreger
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schattke
authors.forename: Gabriela
authors.initials: G
authors.lastname: Riemekasten
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Borges
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
authors.forename: Fabian
authors.initials: F
authors.lastname: Knebel
mesh_terms: D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D012595:Scleroderma, Systemic / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D018709:Statistics, Nonparametric; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology