title: Right ventricular thickness as predictor of global myocardial performance in systemic sclerosis: A Doppler tissue imaging study.
abstract: BACKGROUND
  Cardiopulmonary involvement in systemic sclerosis (SSc) is a poor prognostic factor, due to pulmonary hypertension and right ventricular dysfunction. We assessed the echocardiographic parameters of right ventricular (RV) function in SSc and correlated echocardiographic findings to clinical features of the disease.
  
  
  METHODS
  Thirty patients with SSc (cases) and 30 healthy, age-matched subjects (controls) were studied. Echocardiography, including tissue Doppler imaging, was used to evaluate cardiac function.
  
  
  RESULTS
  Pulmonary hypertension could be documented in only 5 cases by Doppler echo, using Bernoulli principle. RV diastolic function was significantly deranged in cases. RV systolic function and left ventricle (LV) diastolic function were also significantly deranged in the cases. RV thickness was increased in patients with SSc. There were no significant differences in the echocardiographic variables between diffuse and limited subtypes of SSc. Myocardial performance index (MPI) of both ventricles were increased in cases. We could demonstrate RV thickness as the single most important predictor of MPI of both ventricles with sensitivity of 82% and specificity of 72% for RV-MPI and 63% for LV-MPI. Diastolic function was not found to be affected by disease duration or Rodnan skin score.
  
  
  CONCLUSIONS
  Patients with SSc exhibit abnormal RV and LV diastolic functions as well as abnormal RV systolic function. RV wall thickness was found to be simple and the single best predictor of global myocardial performance. RV dysfunction may be a response to intermittent pulmonary arterial hypertension, lung parenchymal involvement, or secondary to LV diastolic dysfunction in SSc.
authors.affiliation: Assistant Professor, Department of Cardiology, Pramukhswami Medical College, Anand, Gujarat 388325, India. Electronic address: karna_sunil@hotmail.com.
authors.forename: S K
authors.initials: SK
authors.lastname: Karna
authors.affiliation: Additional Professor, Department of Cardiology, PGIMER, Chandigarh 160012, India.
authors.forename: M K
authors.initials: MK
authors.lastname: Rohit
authors.affiliation: Associate Professor, Division of Arthritis and Rheumatic Diseases, Oregon Health and Science University, Portland, OR 97239, USA.
authors.forename: A
authors.initials: A
authors.lastname: Wanchu
mesh_terms: D000328:Adult; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D015203:Reproducibility of Results; D012595:Scleroderma, Systemic / Q000150:complications*; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: Doppler tissue imaging; Pulmonary hypertension; Systemic sclerosis; Tei index