Murat Demirci, Burcu Özdemir, Gülçin Zengin, Mustafa Oğuz, Murat Sünbül, Nurten Sayar
{"title":"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","authors":"Murat Demirci, Burcu Özdemir, Gülçin Zengin, Mustafa Oğuz, Murat Sünbül, Nurten Sayar","doi":"10.1002/jcu.24094","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%.</p><p><strong>Conclusion: </strong>SSc patients with ILD exhibit significant cardiac dysfunction and higher 5-year mortality compared to those without ILD.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cardiac Dysfunction and 5-Year Mortality in Patients With Systemic Sclerosis and Interstitial Lung Disease: A Speckle-Tracking Echocardiography Study.\",\"authors\":\"Murat Demirci, Burcu Özdemir, Gülçin Zengin, Mustafa Oğuz, Murat Sünbül, Nurten Sayar\",\"doi\":\"10.1002/jcu.24094\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%.</p><p><strong>Conclusion: </strong>SSc patients with ILD exhibit significant cardiac dysfunction and higher 5-year mortality compared to those without ILD.</p>\",\"PeriodicalId\":15386,\"journal\":{\"name\":\"Journal of Clinical Ultrasound\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-05-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Ultrasound\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jcu.24094\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ACOUSTICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Ultrasound","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jcu.24094","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ACOUSTICS","Score":null,"Total":0}
Cardiac Dysfunction and 5-Year Mortality in Patients With Systemic Sclerosis and Interstitial Lung Disease: A Speckle-Tracking Echocardiography Study.
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.
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.
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