Evaluation of cardiac abnormalities by Doppler echocardiography in a large nationwide multicentric cohort of patients with systemic sclerosis
Evaluation of cardiac abnormalities by Doppler echocardiography in a large nationwide multicentric cohort of patients with systemic sclerosis
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DOI：
10.1136/ard.2006.057760
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发表时间：
2008-01-01
影响因子：
27.4
通讯作者：
Humbert, M.
中科院分区：
文献类型：
--
作者：
de Groote, P.;Gressin, V.;Humbert, M.
目的：系统性硬化症（SSc）的心肺血管受累越来越受到关注。SSc最严重的并发症之一是肺动脉高压（PAH）。越来越多的人意识到SSc患者的左心室（LV）舒张异常。然而，以前的研究通常是在小人群中进行的。本研究的目的是前瞻性筛选PAH和描述超声心动图参数在一大群SSc patients.Methods：这项前瞻性研究进行了21个中心的SSc在法国。没有严重的肺功能异常，严重的心脏疾病和已知的PAH患者进行多普勒超声心动图进行了参考cardiologist.Results：在570例患者评价，PAH被怀疑在33例，并证实在18例右心导管。LV收缩功能障碍罕见（1.4%）。左室肥厚占22.6%，左室舒张功能不全占17.7%。这些LV异常受年龄、性别和血压的影响。我们确定了一个小组的21例患者的限制性二尖瓣血流模式，在没有任何其他心肺疾病，这表明一个特定的心脏参与SSc.Conclusions：左，右心脏疾病，包括PAH，左室肥厚和舒张功能障碍，是常见的SSc。然而，一小部分没有任何心脏或肺部疾病的患者具有限制性二尖瓣血流模式，这可能是由于SSc的原发性心脏受累。将在该队列的3年随访中评价LV异常的预后影响。
Objectives: There is increasing concern about heart and pulmonary vascular involvement in systemic sclerosis (SSc). One of the most severe complications of SSc is pulmonary arterial hypertension (PAH). There has been an increased awareness of left ventricular (LV) diastolic abnormalities in SSc patients. However, previous studies have generally been conducted in small populations. The aims of this study were to prospectively screen for PAH and to describe echocardiographic parameters in a large group of SSc patients.Methods: This prospective study was conducted in 21 centres for SSc in France. Patients without severe pulmonary function abnormalities, severe cardiac disease and known PAH underwent Doppler echocardiography performed by a reference cardiologist.Results: Of the 570 patients evaluated, PAH was suspected in 33 patients and was confirmed in 18 by right heart catheterisation. LV systolic dysfunction was rare (1.4%). LV hypertrophy was found in 22.6%, with LV diastolic dysfunction in 17.7%. These LV abnormalities were influenced by age, gender and blood pressure. We identified a small group of 21 patients with a restrictive mitral flow pattern in the absence of any other cardiopulmonary diseases, suggesting a specific cardiac involvement in SSc.Conclusions: Left and right heart diseases, including PAH, LV hypertrophy and diastolic dysfunction, are common in SSc. However, a small subset of patients without any cardiac or pulmonary diseases have a restrictive mitral flow pattern that could be due to primary cardiac involvement of SSc. The prognostic implications of the LV abnormalities will be evaluated in the 3-year follow-up of this cohort.