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The relationship between global longitudinal strain and pulmonary function tests in patients with scleroderma and normal ejection fraction and pulmonary artery pressure: a case–control study

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Abstract

This study examined the relationship between global longitudinal strain (GLS) and pulmonary function tests (PFT) in patients with systemic sclerosis (SS) and normal ejection fraction (EF) and pulmonary artery pressure (PAP) and healthy controls. Sixty patients in two groups underwent extensive screening, including echocardiography, physical examination, the modified Rodnan Skin Score, and pulmonary function tests. Pulmonary interstitial disease was diagnosed by the pulmonary function test and by CT scan in case of indication. GLS score was computed as the mean peak systolic strain for 17 segments. The mean GLS score was − 18.36 ± 2.1 in the case group and − 20.66 ± 1.6 in the control group (P value < 0.001). GLS scores had a significant inverse relationship with the forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) ratio (P value = 0.049) and both FEV and FVC in patients younger than 35 years old (P = 0.046 and 0.049, respectively). GLS scores had no significant relationship with time elapsed since the onset of skin manifestations, and Raynaud phenomenon, Rodnan score, EF, systolic PAP, or the six-minute walk test results. The patients' six-minute walk test had a significant positive relationship with FVC and right ventricular end diastolic diameter (P value = 0.018 and 0.047, respectively). According to our findings, GLS is significantly lower in patients with SS (with normal EF & PAP) than in healthy individuals. It is also related with certain pulmonary function indices including FEV1/FVC. The reduction in GLS is associated with reduced pulmonary function strength.

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References

  1. Cadeddu Ch, Deidda M (2015) Contractile reserve in systemic sclerosis patients as a major predictor of global cardiac impairment and exercise tolerance. Int J Cardiovasc Imaging 31:529–536

    Article  Google Scholar 

  2. Van den Hoogen F, Khanna D, Fransen J et al (2013) Classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 65:2737–2747

    Article  Google Scholar 

  3. Barnes J, Mayes MD (2012) Epidemiology of systemic sclerosis: incidence, prevalence, survival, risk factors, malignancy, and environmental triggers. Curr Opin Rheumatol 24:165–170

    Article  Google Scholar 

  4. Tyndall AJ, Bannert B, Vonk M et al (2010) Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database. Ann Rheum Dis 69:1809–1815

    Article  Google Scholar 

  5. Hachulla E, Carpentier P, Gressin V et al (2009) Risk factors for death and the 3-year survival of patients with systemic sclerosis: the French ItinérAIR-Sclérodermie study. Rheumatology (Oxford) 48:304–308

    Article  Google Scholar 

  6. Khanna D, Clements PhJ et al (2005) Correlation of the degree of dyspnea with health-related quality of life, functional abilities, and diffusing capacity for carbon monoxide in patients with systemic sclerosis and active alveolitis. Am Coll Rheumatol 52(2):592–600

    Google Scholar 

  7. Steen VD, Conte C, Owens GR, Medsger TA Jr (1994) Severe restrictive lung disease in systemic sclerosis. Arthritis Rheum 37:1283–1289

    Article  CAS  Google Scholar 

  8. Bulkley BH, Ridolfi RL, Salyer WR, Hutchins GM (1976) Myocardial lesions of progressive systemic sclerosis. A cause of cardiac dysfunction. Circulation 53:483–490

    Article  CAS  Google Scholar 

  9. Desai CS, Lee DC (2011) Shah SJ Systemic sclerosis and the heart: current diagnosis and management. Curr Opin Rheumatol 23:545–554

    Article  Google Scholar 

  10. Mizuno R, Fujimoto S, Saito Y, Nakamura S (2010) Cardiac Raynaud’s phenomenon induced by cold provocation as a predictor of long-term left ventricular dysfunction and remodelling in systemic sclerosis: 7-year follow-up study. Eur J Heart Fail 12:268–275

    Article  Google Scholar 

  11. Krishnasamy R, Isbel NM et al (2015) Left ventricular global longitudinal strain (GLS) is a superior predictor of all-cause and cardiovascular mortality when compared to ejection fraction in advanced chronic kidney disease. PLoS ONE 10(5):e0127044

    Article  Google Scholar 

  12. Amundsen BH, Helle-Valle T, Edvardsen T, Torp H, Crosby J, Lyseggen E et al (2006) Noninvasive myocardial strain measurement by speckle tracking echocardiography: validation against sonomicrometry and tagged magnetic resonance imaging. J Am Coll Cardiol 47(4):789–793

    Article  Google Scholar 

  13. Belghitia H, Brette S et al (2008) Automated function imaging: a new operator-independent strain method for assessing left ventricular function. Arch Cardiovasc Dis 101(3):163–169

    Article  CAS  Google Scholar 

  14. Van Den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, Matucci-Cerinic M, Naden RP, Medsger TA Jr, Carreira PE, Riemekasten G (2013) 2013 Classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 65(11):2737–2747

    Article  Google Scholar 

  15. Miller MR, Hankinson J et al (2005) Standardisation of spirometry. Eur Respir J 26:319–338

    Article  CAS  Google Scholar 

  16. Delgado V, Ypenburg C et al (2008) Assessment of left ventricular dyssynchrony by speckle tracking strain imaging comparison between longitudinal, circumferential, and radial strain in cardiac resynchronization therapy. J Am Coll Cardiol 51:1944–1952

    Article  Google Scholar 

  17. Yiu KH et al (2011) Left ventricular dysfunction assessed by speckle-tracking strain analysis in patients with systemic sclerosis-relationship to functional capacity and ventricular arrhythmias. Am Coll Rheumatol 63(12):3969–3978

    Google Scholar 

  18. Yiu KH, Schouffoer AA, Marsan NA, Ninaber MK, Stolk J, Vlieland TV, Scherptong RW, Delgado V, Holman ER, Tse HF, Huizinga TW (2011) Left ventricular dysfunction assessed by speckle-tracking strain analysis in patients with systemic sclerosis: relationship to functional capacity and ventricular arrhythmias. Arthritis Rheum 63(12):3969–3978

    Article  Google Scholar 

  19. Lindholm A, Hesselstrand R, Radegran G, Arheden H, Ostenfeld E (2019) Decreased biventricular longitudinal strain in patients with systemic sclerosis is mainly caused by pulmonary hypertension and not by systemic sclerosis per se. Eur Heart J 39(3):215–225. https://doi.org/10.1111/cpf.12561

    Article  Google Scholar 

  20. Guerra F, Stronati G, Fischietti C, Ferrarini A, Zuliani L, Pomponio G, Capucci A, Danieli MG, Gabrielli A (2018) Global longitudinal strain measured by speckle tracking identifies subclinical heart involvement in patients with systemic sclerosis. Eur J Prev Cardiol 25(15):204748731878631

    Article  Google Scholar 

  21. Sheikh V, Basiri Z, Esna Ashari F, Jabari M, Pishva Y (2012) High-resolution computed tomography and chest X-ray findings of interstitial lung disease related to systemic sclerosis. Avicenna J Clin Med 19(2):16–22

    Google Scholar 

  22. Spethmann S, Dreger H et al (2012) Two-dimensional speckle tracking of the left ventricle in patients with systemic sclerosis for an early detection of myocardial involvement. Eur Heart J 13:863–870

    Google Scholar 

  23. Le Gouellec N, Duhamel A, Perez T, Hachulla AL, Sobanski V, Faivre JB (2017) Predictors of ling function test severity and outcome in systemic sclerosis-associated interstitial lung disease. PLoS ONE 12(8):e0181692. https://doi.org/10.1371/journal.pone.0181692

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Impens J, Wangkaew S, Seibold JR (2008) The 6-minute walk test in scleroderma—how measuring everything measures nothing. Rheumatology (Oxford) 47(suppl 5):v68-v69

    Article  Google Scholar 

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The study has been performed in Rasool Akram Hospital.

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Correspondence to Pejman Mansouri.

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Hajsadeghi, S., Mirshafiee, S., Pazoki, M. et al. The relationship between global longitudinal strain and pulmonary function tests in patients with scleroderma and normal ejection fraction and pulmonary artery pressure: a case–control study. Int J Cardiovasc Imaging 36, 883–888 (2020). https://doi.org/10.1007/s10554-020-01788-7

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  • DOI: https://doi.org/10.1007/s10554-020-01788-7

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