title: Evaluation of global function of the heart in scleroderma patients.
abstract: OBJECTIVE
  Scleroderma is a connective tissue disease characterized by diffuse vascular lesions and fibrosis of the skin and major organs including lungs, kidneys, and heart. When cardiac involvement is clinically evident, it is recognized as a poor prognostic factor. The early detection of cardiac involvement in scleroderma would be desirable both for implementation of preventive measures in the early stages of the disease and for optimal treatment.
  
  
  METHODS
  Left (LV) and right (RV) ventricular function were examined in 31 scleroderma patients and 21 healthy controls. Conventional and tissue Doppler echocardiography was used to evaluate systolic and diastolic function. Systolic indices including systolic (S) velocity, isovolumetric acceleration (IVA), ejection time (ET), and isovolumetric contraction time (IVCT) were measured. Early diastolic (E) velocity, late diastolic (A) velocity, E/A and E'/A' ratios, isovolumetric relaxation time (IVRT), and deceleration time (DT) were the diastolic measurements obtained. Myocardial performance index (Tei index) calculated by 2 different methods was used to assess global ventricular function.
  
  
  RESULTS
  In our study; mitral S velocity, biventricular ET, E', E/A, E'/A', RV IVA, LV IVA, and tricuspid S velocity were significantly lower in scleroderma patients. Mitral DT, IVCT, and biventricular IVRT, were significantly higher in scleroderma patients (P < 0.0001). In addition, RV and LV Tei indices were significantly increased in scleroderma patients compared with the control group (P < 0.0001 and P < 0.001, respectively).
  
  
  CONCLUSIONS
  In scleroderma patients, global function was depressed prior to the onset of clinical symptoms. Biventricular diastolic and systolic function abnormalities were also observed.
authors.affiliation: Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Demet Menekse
authors.initials: DM
authors.lastname: Gerede
authors.affiliation: Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Turhan
authors.affiliation: Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Refika
authors.initials: R
authors.lastname: Hural
authors.affiliation: Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Acıbuca
authors.affiliation: Department of Rheumatology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Kucuksahin
authors.affiliation: Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Ozgur Ulas
authors.initials: OU
authors.lastname: Ozcan
authors.affiliation: Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Goksuluk
authors.affiliation: Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Veysel Kutay
authors.initials: VK
authors.lastname: Vurgun
authors.affiliation: Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Cetin
authors.initials: C
authors.lastname: Erol
mesh_terms: D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; 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; D018754:Ventricular Dysfunction / Q000000981:diagnostic imaging* / Q000209:etiology*
keywords: myocardial performance index; scleroderma; tissue Doppler echocardiography