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Velagapudi S, Sharma B, Hussain K, Sana MK, Kannayiram S, Murthi M, Khanal S, Gomez J. Speckle tracking echocardiography in patients with systemic sclerosis: a meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Myocardial dysfunction is well established in systemic sclerosis (SSc). The utility of standard echocardiography is limited to detect the onset of myocardial dysfunction. Speckle tracking echocardiography (STE) and strain imaging has emerged as a useful technique to quantify left ventricle hemodynamics and myocardial function in early stages of myocardial dysfunction. We aimed to systematically analyze the existing literature on the application of STE and strain analysis in identifying SSc associated myocardial dysfunction
Methods
PubMed, Cochrane, and Google Scholar were queried for studies from the inception of the databases to 2022. Case control studies that used 2D STE for assessment of strain in SSc patients and controls, were included for the analysis. PRISMA guidelines were followed for selections of studies. Two independent reviewers extracted data. Analysis was done using Cochrane Review Manager 5.0.
Results
Total of 19 studies were included in the analysis that compared strain analysis in SSc patient's vs healthy controls. Of the 16 studies that reported left ventricular (LV) global longitudinal strain, we found significantly lower LV global longitudinal strain in SSc patients (mean difference 1.92; 95% CI 0.98–2.87). Six studies reported LV circumferential strain which was noted to be lower in SSc patients compared to healthy controls (mean difference 3.55; 95% CI 1.60–5.51). Five studies reported LV global radial strain with a similar decrease in radial strain among SSc patients compared to controls (mean difference 4.39; 95% CI −6.95 to −1.83). 10 studies reported right ventricular longitudinal strain with a decrease in longitudinal strain in SSc patient's vs controls (mean difference 2.57; 95% CI 2.03–3.12).
Conclusions
SSc patients have lower strain values compared to controls, which is suggestive of an impaired myocardial function in left and right ventricle. Strain analysis by STE could help with early detection of myocardial dysfunction.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Velagapudi
- John H. Stroger Jr. Hospital of Cook County , Chicago , United States of America
| | - B Sharma
- John H. Stroger Jr. Hospital of Cook County , Chicago , United States of America
| | - K Hussain
- NorthShore University Health System , Chicago , United States of America
| | - M K Sana
- John H. Stroger Jr. Hospital of Cook County , Chicago , United States of America
| | - S Kannayiram
- John H. Stroger Jr. Hospital of Cook County , Chicago , United States of America
| | - M Murthi
- John H. Stroger Jr. Hospital of Cook County , Chicago , United States of America
| | - S Khanal
- John H. Stroger Jr. Hospital of Cook County , Chicago , United States of America
| | - J Gomez
- John H. Stroger Jr. Hospital of Cook County , Chicago , United States of America
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