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Unveiling Cardiac Involvement in Juvenile Dermatomyositis Through Speckle-Tracking Echocardiography

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Abstract

Early detection of cardiac involvement in Juvenile Dermatomyositis (JDM) is difficult due to the absence of clinical signs and symptoms, with systolic dysfunction often emerging in late stages and associated with a poor prognosis. This study aimed to employ two-dimensional speckle-tracking echocardiography (STE) for subclinical assessment of left ventricular (LV) systolic failure in JDM and explore potential associations between impaired LV systolic function (LV-GLS) and disease activity. A prospective study enrolled 20 healthy volunteers and 26 JDM patients (< 18 years old) without cardiac symptoms. Clinical data were collected from medical records, and echocardiograms were conducted by a pediatric cardiologist. Our study cohort demonstrated similar age to controls (13.5 ± .6 vs. 13.8 ± 4.7; p = 0.465). Median illness duration at echocardiography was 5 (1.5–17.5) years, and conventional echocardiography indicated normal LV ejection fraction (> 55%) in all participants. However, STE revealed lowered LV GLS in JDM patients (− 22.2 ± 4.1% vs. − 26.5 ± 5.3% p = 0.022). Pulse steroid users displayed lower GLS average values compared to non-users (β = 4.99, 95% CI 1.34–8.64, p = 0.009). Negative correlations existed between LV-GLS and age at diagnosis (r = − 0.499; p = 0.011), diastolic parameters (E/E′ ratio) and age at diagnosis (r = − 0.469; p = 0.018), as well as RV global strain and age at diagnosis (r = − 0.443; p = 0.024). Employing STE in JDM patients facilitated the identification of preclinical cardiac dysfunction. Given JDM patients' younger age, early myocardial damage detection through STE may impact treatment decisions and long-term cardiovascular prognosis.

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References

  1. Papadopoulou C, McCann LJ (2018) The vasculopathy of juvenile dermatomyositis. Front Pediatr 6:284. https://doi.org/10.3389/fped.2018.00284

    Article  PubMed  PubMed Central  Google Scholar 

  2. Barut K, Aydin PO, Adrovic A, Sahin S, Kasapcopur O (2017) Juvenile dermatomyositis: a tertiary center experience. Clin Rheumatol 36(2):361–366. https://doi.org/10.1007/s10067-016-3530-4

    Article  PubMed  Google Scholar 

  3. Witczak BN, Schwartz T, Barth Z et al (2022) Associations between cardiac and pulmonary involvement in patients with juvenile dermatomyositis—a cross-sectional study. Rheumatol Int 42(7):1213–1220. https://doi.org/10.1007/s00296-021-05071-

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Ghosh R, Roy D, Dubey S, Abdelrahman K, Ray BK (2020) Juvenile dermatomyositis presenting as complete heart block in a 10-year-old girl. Paediatr Int Child Health 40(4):251–254. https://doi.org/10.1080/20469047.2020.1765123

    Article  PubMed  Google Scholar 

  5. Schwartz T, Sanner H, Gjesdal O, Flato B, Sjaastad I (2014) In juvenile dermatomyositis, cardiac systolic dysfunction is present after long-term follow-up and is predicted by sustained early skin activity. Ann Rheum Dis 73:1805–1810. https://doi.org/10.1136/annrheumdis-2013-203279

    Article  PubMed  Google Scholar 

  6. Guerra F, Gelardi C, Capucci A, Gabrielli A, Danieli MG (2017) Subclinical cardiac dysfunction in polymyositis and dermatomyositis: a speckle-tracking case-control study. J Rheumatol 44:815–821. https://doi.org/10.3899/jrheum.161311

    Article  CAS  PubMed  Google Scholar 

  7. Diniz MFR, Kozu KT, Elias AM et al (2021) Echocardiographic study of juvenile dermatomyositis patients: new insights from speckle-tracking-derived strain. Clin Rheumatol 40(4):1497–1505. https://doi.org/10.1007/s10067-020-05418-4

    Article  PubMed  Google Scholar 

  8. Bohan A, Peter JB (1975) Polymyositis and dermatomyositis. N Engl J Med 13:344–347. https://doi.org/10.1056/NEJM197502132920706

    Article  Google Scholar 

  9. Dulcan M (1994) Nomenclature and criteria for diagnosis of diseases of the heart and great vessels, 9th edn. Little, Brown & Co, , Boston, pp 253–256

    Google Scholar 

  10. Ruperto N, Martini A (2011) Networking in paediatrics: the example of the paediatric rheumatology international trials organisation (PRINTO). Arch Dis Child 96(6):596–601

    Article  PubMed  Google Scholar 

  11. Huber AM, Feldman BM, Rennebohm RM et al (2004) Validation and clinical significance of the childhood myositis assessment scale for assessment of muscle function in the juvenile idiopathic inflammatory myopathies. Arthritis Rheum 50:1595–1603. https://doi.org/10.1002/art.20179

    Article  PubMed  Google Scholar 

  12. Haycock GB, Schwartz GJ, Wisotsky DH (1978) Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr 93:62–66. https://doi.org/10.1016/s0022-3476(78)80601-5

    Article  CAS  PubMed  Google Scholar 

  13. Mor-Avi V, Lang RM, Badano LP et al (2011) Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese society of echocardiography. J Am Soc Echocardiogr 24:277–313. https://doi.org/10.1016/j.echo.2011.01.015

    Article  PubMed  Google Scholar 

  14. Levy PT, Machefsky A, Sanchez AA et al (2016) Reference ranges of left ventricular strain measures by two-dimensional speckle-tracking echocardiography in children: a systematic review and meta-analysis. J Am Soc Echocardiogr 29:209–225. https://doi.org/10.1016/j.echo.2015.11.016

    Article  PubMed  Google Scholar 

  15. Eidem BW, McMahon CJ, Cohen RR et al (2004) Impact of cardiac growth on doppler tissue imaging velocities: a study in healthy children. J Am Soc Echocardiogr 17:212–221. https://doi.org/10.1016/j.echo.2003.12.005

    Article  PubMed  Google Scholar 

  16. Lazarevic D, Pistorio A, Palmisani E et al (2013) The PRINTO criteria for clinically inactive disease in juvenile dermatomyositis. Ann Rheum Dis 72(5):686–693. https://doi.org/10.1136/annrheumdis-2012-201483

    Article  CAS  PubMed  Google Scholar 

  17. Dedeoglu R, Şahin S, Koka A et al (2016) Evaluation of cardiac functions in juvenile systemic lupus erythematosus with two-dimensional speckle tracking echocardiography. Clin Rheumatol 35(8):1967–1975. https://doi.org/10.1007/s10067-016-3289-7

    Article  PubMed  Google Scholar 

  18. Dedeoglu R, Adrovic A, Oztunç F et al (2017) New insights into cardiac involvement in juvenile scleroderma: a three-dimensional echocardiographic assessment unveils subclinical ventricle dysfunction. Pediatr Cardiol 38(8):1686–1695. https://doi.org/10.1007/s00246-017-1714-6

    Article  PubMed  Google Scholar 

  19. Yildiz M, Dedeoglu R, Akdeniz B et al (2022) Systolic and diastolic cardiac functions in juvenile spondyloarthropathies. J Clin Rheumatol 28(1):e175–e179. https://doi.org/10.1097/RHU.0000000000001674

    Article  PubMed  Google Scholar 

  20. Fairley JL, Wicks I, Peters S, Day J (2021) Defining cardiac involvement in idiopathic inflammatory myopathies: a systematic review. Rheumatol (Oxford) 61:103–120. https://doi.org/10.1093/rheumatology/keab573

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Cardiology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, Istanbul, Turkey

    Reyhan Dedeoglu, Nujin Ulug Murt, Yusuf İskender Cosgun & Funda Oztunc

  2. Department of Pediatric Rheumatology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, Istanbul, Turkey

    Savas Dedeoglu

  3. Department of Pediatrics, Faculty of Medicine, Uskudar University, Istanbul, Turkey

    Aybüke Gunalp, Amra Adrovic, Sezgin Sahin, Mehmet Yıldız, Kenan Barut, Esma Aslan, Elif Kılıc Konte, Ümit Gul & Ozgur Kasapcopur

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  1. Reyhan Dedeoglu
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  2. Nujin Ulug Murt
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  3. Aybüke Gunalp
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Contributions

RD, OK contributed to the design and data analysis and critically read the final manuscript. NU, AG, YC, SS, FO, AA, KB, SD, UG, EK, EA, MY contributed to data collection, analysis, read and approved the final manuscript.

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Correspondence to Reyhan Dedeoglu.

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The study was approved by the institution review board.

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Informed consent was obtained from the parents or legal guardians of all individual participants included in the study.

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Dedeoglu, R., Murt, N.U., Gunalp, A. et al. Unveiling Cardiac Involvement in Juvenile Dermatomyositis Through Speckle-Tracking Echocardiography. Pediatr Cardiol 45, 1007–1014 (2024). https://doi.org/10.1007/s00246-024-03438-4

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