4.4 Article

Usefulness of Myocardial Strain and Twist for Early Detection of Myocardial Dysfunction in Patients With Autoimmune Diseases

Journal

AMERICAN JOURNAL OF CARDIOLOGY
Volume 125, Issue 3, Pages 475-481

Publisher

EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjcard.2019.10.035

Keywords

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Funding

  1. National Natural Science Foundation of China, Beijing, China [81470426]
  2. Beijing Natural Science Foundation, Beijing, China [7192156]

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Cardiac involvement in autoimmune diseases (AD) is common but underdiagnosed due to a lack of sensitive imaging methods. We aim to evaluate the characteristics of left ventricular (LV) systolic dysfunction in patients with AD using deformational parameters from 2-dimensional speckle-tracking echocardiography (STE). We retrospectively enrolled 86 AD patients and 71 healthy controls. All subjects underwent transthoracic echocardiography and STE to analyze LV strain and twist. A twist-radial displacement loop was constructed to investigate the relation between LV contractility and dimension. In AD patients, 68 had preserved LV ejection fraction (EF >= 50%), and 18 had reduced LVEF (EF < 50%). The patients with preserved LVEF exhibited significantly lower values of global longitudinal, circumferential, and radial strain than controls (-19.11 +/- 4.18 vs -21.49 +/- 2.53%, -25.17 +/- 5.04% vs -27.37 +/- 2.87%, 17.68 +/- 5.69% vs 21.17 +/- 6.44%, respectively; all p <0.01) and a marked attenuation in peak twist (14.24 +/- 5.57 vs 18.10 +/- 5.97, p <0.01) attributed to impaired apical rotation (9.03 +/- 5.17 vs 12.79 +/- 5.99, p <0.01). AD patients were more likely to present with abnormal loop types with flat ascending slope and delayed peak twist time. In conclusion, abnormal strain and twist precede deterioration in LVEF, suggesting early myocardial involvement in AD. STE can be used as a good alternative for early detection of myocardial dysfunction in AD patients. (C) 2019 Elsevier Inc. All rights reserved.

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