Mihnea Casian, Alina Dima, Ciprian Jurcuț, Laura Andrei, Jamie Edwards, Jamie O'Driscoll, Bogdan A Popescu, Ruxandra Jurcuț
{"title":"系统性硬化症的心功能和力学：系统回顾和荟萃分析。","authors":"Mihnea Casian, Alina Dima, Ciprian Jurcuț, Laura Andrei, Jamie Edwards, Jamie O'Driscoll, Bogdan A Popescu, Ruxandra Jurcuț","doi":"10.1186/s44156-025-00081-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to evaluate differences in conventional, tissue Doppler imaging (TDI) and speckle-tracking echocardiographic (STE) parameters of all cardiac chambers between SSc patients and healthy controls.</p><p><strong>Methods: </strong>A study search strategy based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed. MEDLINE, Scopus and Web of Science were searched using the following keywords: \"speckle tracking\", \"global strain\", \"longitudinal strain\", \"circumferential strain\", \"radial strain\", \"atrial strain\", \"right ventricular strain\", or \"left ventricular strain\" and \"systemic sclerosis\". Primary pooled analyses were performed on each cardiac parameter independently to determine the weighted mean difference (WMD) between SSc and controls. Further independent subgroup analyses were performed to compare symptomatic vs asymptomatic SSc and diffuse vs limited SSc.</p><p><strong>Results: </strong>The systematic review and meta-analysis included 41 case-control eligible reports studies with a pooled sample size of 2497 SSc cases and 1439 controls. Significant weighted mean differences (WMD) between SSc patients and healthy controls were identified in septal S' wave (WMD 0.343 cm/s, CI [- 0.540-0.145], I<sup>2</sup>: 36%, p = 0.001), lateral S' wave (WMD 0.795 cm/s, CI [- 1.394-0.197], I<sup>2</sup>: 0%, p = 0.009), tricuspid S' wave (WMD 1.137 cm/s, CI [- 1.784-0.489], I<sup>2</sup>: 84%, p = 0.001), septal e' wave (WMD 1.398 cm/s, CI [- 2.272-0.523], I<sup>2</sup>: 82%, p = 0.002) and lateral e' wave (WMD 3.545 cm/s, CI [- 4.990-2.100], I<sup>2</sup>: 71%, p < 0.001) velocities. STE parameters were attenuated in patients with SSc, with impairment of left ventricular global longitudinal (WMD 2.765%, CI [- 3.482-2.049], I<sup>2</sup>: 91%, p < 0.001), circumferential (WMD 3.145%, CI [- 4.181-2.109], I<sup>2</sup>: 79%, p < 0.001), and radial (WMD 4.044%, CI [- 6.199-1.889], I<sup>2</sup>: 0%, p < 0.001) strain, right ventricular free wall (WMD 4.492%, CI [- 6.048-2.937], I<sup>2</sup>: 76%, p < 0.001) and right ventricular global longitudinal strain (WMD 2.843%, CI [- 3.290-2.396], I<sup>2</sup>: 32%, p < 0.001), as well as left (WMD - 8.317%, CI [- 11.873-4.761], I<sup>2</sup>: 82%, p < 0.001) and right (WMD 7.346%, CI [- 10.536-4.156], I<sup>2</sup>: 26%, p < 0.001) atrial reservoir strain.</p><p><strong>Conclusion: </strong>SSc is associated with significantly impaired cardiac function and mechanics compared to healthy individuals, even in the absence of symptoms or pulmonary hypertension.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"18"},"PeriodicalIF":2.4000,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257727/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cardiac function and mechanics in systemic sclerosis: a systematic review and meta-analysis.\",\"authors\":\"Mihnea Casian, Alina Dima, Ciprian Jurcuț, Laura Andrei, Jamie Edwards, Jamie O'Driscoll, Bogdan A Popescu, Ruxandra Jurcuț\",\"doi\":\"10.1186/s44156-025-00081-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The study aimed to evaluate differences in conventional, tissue Doppler imaging (TDI) and speckle-tracking echocardiographic (STE) parameters of all cardiac chambers between SSc patients and healthy controls.</p><p><strong>Methods: </strong>A study search strategy based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed. MEDLINE, Scopus and Web of Science were searched using the following keywords: \\\"speckle tracking\\\", \\\"global strain\\\", \\\"longitudinal strain\\\", \\\"circumferential strain\\\", \\\"radial strain\\\", \\\"atrial strain\\\", \\\"right ventricular strain\\\", or \\\"left ventricular strain\\\" and \\\"systemic sclerosis\\\". Primary pooled analyses were performed on each cardiac parameter independently to determine the weighted mean difference (WMD) between SSc and controls. Further independent subgroup analyses were performed to compare symptomatic vs asymptomatic SSc and diffuse vs limited SSc.</p><p><strong>Results: </strong>The systematic review and meta-analysis included 41 case-control eligible reports studies with a pooled sample size of 2497 SSc cases and 1439 controls. Significant weighted mean differences (WMD) between SSc patients and healthy controls were identified in septal S' wave (WMD 0.343 cm/s, CI [- 0.540-0.145], I<sup>2</sup>: 36%, p = 0.001), lateral S' wave (WMD 0.795 cm/s, CI [- 1.394-0.197], I<sup>2</sup>: 0%, p = 0.009), tricuspid S' wave (WMD 1.137 cm/s, CI [- 1.784-0.489], I<sup>2</sup>: 84%, p = 0.001), septal e' wave (WMD 1.398 cm/s, CI [- 2.272-0.523], I<sup>2</sup>: 82%, p = 0.002) and lateral e' wave (WMD 3.545 cm/s, CI [- 4.990-2.100], I<sup>2</sup>: 71%, p < 0.001) velocities. STE parameters were attenuated in patients with SSc, with impairment of left ventricular global longitudinal (WMD 2.765%, CI [- 3.482-2.049], I<sup>2</sup>: 91%, p < 0.001), circumferential (WMD 3.145%, CI [- 4.181-2.109], I<sup>2</sup>: 79%, p < 0.001), and radial (WMD 4.044%, CI [- 6.199-1.889], I<sup>2</sup>: 0%, p < 0.001) strain, right ventricular free wall (WMD 4.492%, CI [- 6.048-2.937], I<sup>2</sup>: 76%, p < 0.001) and right ventricular global longitudinal strain (WMD 2.843%, CI [- 3.290-2.396], I<sup>2</sup>: 32%, p < 0.001), as well as left (WMD - 8.317%, CI [- 11.873-4.761], I<sup>2</sup>: 82%, p < 0.001) and right (WMD 7.346%, CI [- 10.536-4.156], I<sup>2</sup>: 26%, p < 0.001) atrial reservoir strain.</p><p><strong>Conclusion: </strong>SSc is associated with significantly impaired cardiac function and mechanics compared to healthy individuals, even in the absence of symptoms or pulmonary hypertension.</p>\",\"PeriodicalId\":45749,\"journal\":{\"name\":\"Echo Research and Practice\",\"volume\":\"12 1\",\"pages\":\"18\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-07-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257727/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Echo Research and Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s44156-025-00081-4\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Echo Research and Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s44156-025-00081-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究旨在评价SSc患者与健康对照组在常规、组织多普勒成像（TDI）和斑点跟踪超声心动图（STE）各心室参数的差异。方法：采用基于系统评价和荟萃分析首选报告项目（PRISMA）的研究检索策略。使用以下关键词检索MEDLINE、Scopus和Web of Science：“斑点追踪”、“全局应变”、“纵向应变”、“周向应变”、“径向应变”、“心房应变”、“右心室应变”或“左心室应变”和“系统性硬化症”。对每个心脏参数进行独立的初步汇总分析，以确定SSc和对照组之间的加权平均差（WMD）。进一步进行独立亚组分析，比较有症状与无症状的SSc以及弥漫性与局限性SSc。结果：系统评价和荟萃分析包括41份病例对照合格报告，共纳入2497例SSc病例和1439例对照。加权平均数差异显著(WMD) SSc患者和健康对照组之间在隔年代被确定的波(大规模杀伤性武器0.343厘米/秒,CI (-0.145 - 0.540), I2: 36%, p = 0.001),横向S波(大规模杀伤性武器0.795厘米/秒,CI (-0.197 - 1.394), I2: 0%, p = 0.009),三尖瓣年代的波(大规模杀伤性武器1.137厘米/秒,CI (-0.489 - 1.784), I2: 84%, p = 0.001),间隔e”波(大规模杀伤性武器1.398厘米/秒,CI (-0.523 - 2.272), I2: 82%, p = 0.002)和横向e波(大规模杀伤性武器3.545厘米/秒,CI (-2.100 - 4.990), I2: 71%, p 2: 91%, p 2: 79%, p 2: 0%, p 2:结论：与健康个体相比，即使在没有症状或肺动脉高压的情况下，SSc也与心功能和力学功能明显受损相关。
Cardiac function and mechanics in systemic sclerosis: a systematic review and meta-analysis.
Objectives: The study aimed to evaluate differences in conventional, tissue Doppler imaging (TDI) and speckle-tracking echocardiographic (STE) parameters of all cardiac chambers between SSc patients and healthy controls.
Methods: A study search strategy based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed. MEDLINE, Scopus and Web of Science were searched using the following keywords: "speckle tracking", "global strain", "longitudinal strain", "circumferential strain", "radial strain", "atrial strain", "right ventricular strain", or "left ventricular strain" and "systemic sclerosis". Primary pooled analyses were performed on each cardiac parameter independently to determine the weighted mean difference (WMD) between SSc and controls. Further independent subgroup analyses were performed to compare symptomatic vs asymptomatic SSc and diffuse vs limited SSc.
Results: The systematic review and meta-analysis included 41 case-control eligible reports studies with a pooled sample size of 2497 SSc cases and 1439 controls. Significant weighted mean differences (WMD) between SSc patients and healthy controls were identified in septal S' wave (WMD 0.343 cm/s, CI [- 0.540-0.145], I2: 36%, p = 0.001), lateral S' wave (WMD 0.795 cm/s, CI [- 1.394-0.197], I2: 0%, p = 0.009), tricuspid S' wave (WMD 1.137 cm/s, CI [- 1.784-0.489], I2: 84%, p = 0.001), septal e' wave (WMD 1.398 cm/s, CI [- 2.272-0.523], I2: 82%, p = 0.002) and lateral e' wave (WMD 3.545 cm/s, CI [- 4.990-2.100], I2: 71%, p < 0.001) velocities. STE parameters were attenuated in patients with SSc, with impairment of left ventricular global longitudinal (WMD 2.765%, CI [- 3.482-2.049], I2: 91%, p < 0.001), circumferential (WMD 3.145%, CI [- 4.181-2.109], I2: 79%, p < 0.001), and radial (WMD 4.044%, CI [- 6.199-1.889], I2: 0%, p < 0.001) strain, right ventricular free wall (WMD 4.492%, CI [- 6.048-2.937], I2: 76%, p < 0.001) and right ventricular global longitudinal strain (WMD 2.843%, CI [- 3.290-2.396], I2: 32%, p < 0.001), as well as left (WMD - 8.317%, CI [- 11.873-4.761], I2: 82%, p < 0.001) and right (WMD 7.346%, CI [- 10.536-4.156], I2: 26%, p < 0.001) atrial reservoir strain.
Conclusion: SSc is associated with significantly impaired cardiac function and mechanics compared to healthy individuals, even in the absence of symptoms or pulmonary hypertension.
期刊介绍：
Echo Research and Practice aims to be the premier international journal for physicians, sonographers, nurses and other allied health professionals practising echocardiography and other cardiac imaging modalities. This open-access journal publishes quality clinical and basic research, reviews, videos, education materials and selected high-interest case reports and videos across all echocardiography modalities and disciplines, including paediatrics, anaesthetics, general practice, acute medicine and intensive care. Multi-modality studies primarily featuring the use of cardiac ultrasound in clinical practice, in association with Cardiac Computed Tomography, Cardiovascular Magnetic Resonance or Nuclear Cardiology are of interest. Topics include, but are not limited to: 2D echocardiography 3D echocardiography Comparative imaging techniques – CCT, CMR and Nuclear Cardiology Congenital heart disease, including foetal echocardiography Contrast echocardiography Critical care echocardiography Deformation imaging Doppler echocardiography Interventional echocardiography Intracardiac echocardiography Intraoperative echocardiography Prosthetic valves Stress echocardiography Technical innovations Transoesophageal echocardiography Valve disease.
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