Cardiac Dysfunction and 5-Year Mortality in Patients With Systemic Sclerosis and Interstitial Lung Disease: A Speckle-Tracking Echocardiography Study.

IF 1.2 4区医学 Q3 ACOUSTICS

Journal of Clinical Ultrasound Pub Date : 2025-05-29 DOI:10.1002/jcu.24094

Murat Demirci, Burcu Özdemir, Gülçin Zengin, Mustafa Oğuz, Murat Sünbül, Nurten Sayar

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引用次数: 0

Abstract

Background/aims: Systemic sclerosis (SSc) is a chronic autoimmune disorder characterized by fibrosis, vascular abnormalities, and immune system activation, often leading to significant cardiac involvement and high mortality. Interstitial lung disease (ILD) is a common complication in SSc, potentially exacerbating cardiac dysfunction. This study aimed to evaluate cardiac function using speckle-tracking echocardiography (STE) and determine the impact of ILD on 5-year mortality in SSc patients.

Methods: In this prospective cohort study, 68 SSc patients were divided into two groups based on the presence of ILD, assessed by thoracic computed tomography (CT): ILD group (n = 32) and non-ILD group (n = 36). Both conventional echocardiography and STE were performed to assess cardiac function, with left ventricular global longitudinal strain (LV GLS) and right ventricular global longitudinal strain (RV GLS) as primary measures. Five-year mortality data were collected and analyzed.

Results: The ILD group exhibited significantly lower LV GLS (-15.62% ± 2.74%) and RV GLS (-16.46% ± 4.38%) compared to the non-ILD group (-18.01% ± 2.73%, p = 0.001 and -20.22% ± 4.30%, p = 0.001, respectively). Atrial strain parameters, including both left and right atrial reservoir and contractile strain, were significantly impaired in the ILD group. Five-year all-cause mortality was significantly higher in the ILD group (46.87%) compared to the non-ILD group (19.44%, p = 0.016). Multivariate logistic regression identified age (OR = 1.120, 95% CI: 1.022-1.226, p = 0.015) and RV GLS (OR = 0.686, 95% CI: 0.550-0.856, p = 0.001) as independent predictors of mortality. RV GLS predicted 5-year mortality with a sensitivity of 86.4% and a specificity of 80.4% at a cut-off value of -17.3%.

Conclusion: SSc patients with ILD exhibit significant cardiac dysfunction and higher 5-year mortality compared to those without ILD.

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系统性硬化症和间质性肺疾病患者的心功能障碍和5年死亡率：斑点跟踪超声心动图研究

背景/目的：系统性硬化症（SSc）是一种以纤维化、血管异常和免疫系统激活为特征的慢性自身免疫性疾病，常导致严重的心脏受累和高死亡率。间质性肺疾病（ILD）是SSc的常见并发症，可能加剧心功能障碍。本研究旨在利用斑点跟踪超声心动图（STE）评估心功能，并确定ILD对SSc患者5年死亡率的影响。方法：在这项前瞻性队列研究中，68例SSc患者根据是否存在ILD分为两组，通过胸部计算机断层扫描（CT）评估：ILD组（n = 32）和非ILD组（n = 36）。以左心室总纵应变（LV GLS）和右心室总纵应变（RV GLS）为主要指标，采用常规超声心动图和STE评估心功能。收集并分析5年死亡率数据。结果：ILD组的LV GLS（-15.62%±2.74%）和RV GLS（-16.46%±4.38%）明显低于非ILD组（-18.01%±2.73%,p = 0.001和-20.22%±4.30%,p = 0.001）。心房应变参数，包括左、右心房蓄能器和收缩应变，在ILD组明显受损。ILD组5年全因死亡率（46.87%）明显高于非ILD组（19.44%,p = 0.016）。多因素logistic回归确定年龄（OR = 1.120, 95% CI: 1.022-1.226, p = 0.015）和RV GLS （OR = 0.686, 95% CI: 0.550-0.856, p = 0.001）为死亡率的独立预测因子。RV GLS预测5年死亡率的敏感性为86.4%，特异性为80.4%，临界值为-17.3%。结论：SSc合并ILD的患者与未合并ILD的患者相比，表现出明显的心功能障碍和更高的5年死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Ultrasound 医学-核医学

CiteScore

1.90

自引率

0.00%

发文量

248

审稿时长

6 months

期刊介绍： The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography. The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents. JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.