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Li Z, Qian Y, Fan CY, Huang Y. Application of three-dimensional speckle tracking technique in measuring left ventricular myocardial function in patients with diabetes. World J Diabetes 2024; 15:783-792. [PMID: 38680686 PMCID: PMC11045408 DOI: 10.4239/wjd.v15.i4.783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/28/2023] [Accepted: 03/07/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Diabetic cardiomyopathy is considered as a chronic complication of diabetes mellitus (DM). Therefore, early detection of left ventricular systolic function (LVSF) damage in DM is essential. AIM To explore the use of the three-dimensional speckle tracking technique (3D-STI) for measuring LVSF in DM patients via meta-analysis. METHODS The electronic databases were retrieved from the initial accessible time to 29 April 2023. The current study involved 9 studies, including 970 subjects. We carried out this meta-analysis to estimate myocardial function in DM compared with controls according to myocardial strain attained by 3D-STI. RESULTS Night articles including 970 subjects were included. No significant difference was detected in the left ventricular ejection fraction between the control and the diabetic group (P > 0.05), while differences in global longitudinal strain, global circumferential strain, global radial strain, and global area strain were markedly different between the controls and DM patients (all P < 0.05). CONCLUSION The 3D-STI could be applied to accurately measure early LVSF damage in patients with DM.
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Affiliation(s)
- Zheng Li
- Department of Ultrasound, The People’s Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu Province, China
| | - Ying Qian
- Department of Ultrasound, The People’s Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu Province, China
| | - Chun-Yun Fan
- Department of Ultrasound, The People’s Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu Province, China
| | - Yong Huang
- Department of Endocrinology, The People’s Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu Province, China
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Vitarelli A, Miraldi F, Capotosto L, Galea N, Francone M, Marchitelli L, Viceconte N, Smaldone C, Mangieri E, Nguyen BL, Tanzilli G, Mancone M, Al-Kindy S. Comprehensive echocardiographic assessment of right ventricular function, pulmonary arterial elastic properties and ventricular-vascular coupling in adult patients with repaired tetralogy of fallot: clinical significance of 3D derived indices. Int J Cardiovasc Imaging 2023; 39:1631-1641. [PMID: 37405609 DOI: 10.1007/s10554-023-02857-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/21/2023] [Indexed: 07/06/2023]
Abstract
We aimed to comprehensively analyze by three-dimensional speckle-tracking echocardiography (3DSTE) and Doppler echocardiography right ventricular (RV) performance, pulmonary arterial (PA) elastic properties and right ventricular-pulmonary artery coupling (RVPAC) in patients with repaired tetralogy of Fallot (rTOF) and assess the feasibility and clinical utility of related echocardiographic indices. Twenty-four adult patients with rTOF and twenty-four controls were studied. RV end-diastolic volume(3D-RVEDV), RV end-systolic volume(3D-RVESV), RV ejection fraction(3D-RVEF), RV longitudinal strain(3D-RVLS) and RV area strain(3D-RVAS) were calculated by 3DSTE. RV end-systolic area (RVESA) was obtained by planimetry. Pulmonary regurgitation (PR) was assessed as trivial/mild or significant by cardiac magnetic resonance (CMR) and color-Doppler. Pulmonary artery (PA) elastic properties were determined using two-dimensional/Doppler echocardiography. RV systolic pressure (RVSP) was measured using standard Doppler methods. RVPAC was assessed using various 3DSTE-derived parameters (3DRVAS/RVSP, 3DRVLS/RVESA, 3DRVAS/RVESV). Overall, 3DRVEF and 3DRVAS were impaired in rTOF patients compared with controls. PA pulsatility and capacitance were reduced (p = 0.003) and PA elastance was higher (p = 0.0007) compared to controls. PA elastance had a positive correlation with 3DRVEDV (r = 0.64, p = 0.002) and 3DRVAS (r = 0.51, p = 0.02). By ROC (receiver operating characteristics) analysis, 3DRVAS/RVESV, 3DRVAS/RVSP and 3DRVLS/RVESA cutoff values of 0.31%/mmHg, 0.57%/mmHg and 0.86%/mmHg, respectively, had 91%, 88% and 88% sensitivity and 81%, 81% and 79% specificity in identifying exercise capacity impairment. In rTOF patients increased 3DSTE-derived RV volumes and impaired RV ejection fraction and strain are associated with reduced PA pulsatility and capacitance and increased PA elastance. 3DSTE-derived RVPAC parameters using different afterload-markers are accurate indices of exercise capacity.
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Affiliation(s)
- Antonio Vitarelli
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy.
- Cardiodiagnostica, via Lima 35, Rome, 00198, Italy.
| | - Fabio Miraldi
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy
| | - Lidia Capotosto
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy
- Cardiodiagnostica, via Lima 35, Rome, 00198, Italy
| | - Nicola Galea
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy
| | - Marco Francone
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy
| | - Livia Marchitelli
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy
| | - Nicola Viceconte
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy
| | | | - Enrico Mangieri
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy
| | - Bich Lien Nguyen
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy
| | - Gaetano Tanzilli
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy
| | - Massimo Mancone
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy
| | - Sulaiman Al-Kindy
- Depts of Cardiology, Cardiac Surgery and Radiology, Sapienza University, Rome, Italy
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Hu S, Zhang H, Ma H, Yang C, Hu P, Gao F. Assessment of right ventricular structure and systolic function in amateur marathon runners using three-dimensional speckle tracking echocardiography. Int J Cardiovasc Imaging 2023; 39:1473-1482. [PMID: 37178419 PMCID: PMC10427556 DOI: 10.1007/s10554-023-02869-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
Prolonged high-intensity endurance exercise has been reported to have adverse effects on the heart, which are further correlated with exercise dose. However, its effect on the right ventricle (RV) of amateur runners is unknown. This study aimed was to evaluate the early right ventricular structure and systolic function of amateur marathon runners by three-dimensional speckle tracking echocardiography (3D-STE), and to further analyze the correlation between relevant parameters and the amount of training. A total of 30 amateur marathon runners (marathon group) and 27 healthy volunteers (control group) were enrolled. Conventional echocardiography combined with 3D-STE was performed in all subjects, and the marathon group was screened by echocardiography a week before a marathon (V1), within 1 h post-marathon (V2), and 4 days post-marathon (V3). RV global longitudinal strain (GLS) and RV end-diastolic volume (EDV) increased significantly in the marathon group compared to the control group (P < 0.05). RV GLS was significantly decreased in the marathon group within 1 h post-marathon (V1: - 26.2 ± 2.5% vs V2: - 23.0 ± 1.6% vs V3: - 25.6 ± 2.6%, P < 0.001). However, there was no significant difference in RV ejection fraction (RVEF) (P > 0.05). The results of the correlation analysis showed that RV EDV and RV end-systolic volume (ESV) were positively correlated with the average training volume (P < 0.001). Multivariate linear regression analysis showed that average training volume was an independent predictor of RV EDV in amateur marathoners (β = 0.642, P < 0.001). The systolic function of the RV was enhanced in amateur marathon runners in the early stage, manifested by an increase in RV EDV. After a long period of high-intensity endurance exercise, RV systolic function will temporarily be reduced. 3D-STE can identify this subclinical change with high sensitivity and provide valuable information to assess the structure and function of RV in amateur marathon runners.
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Affiliation(s)
- Shanting Hu
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China
- School of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Hebin Zhang
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China
- Hangzhou Institute of Sports Medicine for Marathon, Hangzhou, China
| | - Hui Ma
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China
- School of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Cunxin Yang
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China
| | - Peipei Hu
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China
| | - Feng Gao
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China.
- School of Medicine, Hangzhou Normal University, Hangzhou, China.
- Hangzhou Institute of Sports Medicine for Marathon, Hangzhou, China.
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Kuraoka A, Ishizu T, Sato M, Igarashi M, Sato K, Yamamoto M, Machino-Ohtsuka T, Ieda M. Left atrial regional strain assessed by novel dedicated three-dimensional speckle tracking echocardiography. J Cardiol 2021; 78:517-523. [PMID: 34334266 DOI: 10.1016/j.jjcc.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Left atrial (LA) global strain has been studied as an early marker of LA dysfunction, followed by LA dilatation. Recently, a novel dedicated software for LA 3-dimensional speckle tracking echocardiography (LA-3DSTE) has allowed us to assess anatomy-based six-segmental LA deformation. This study aimed to assess the accuracy of LA-3DSTE software in measuring LA volume and to reveal the characteristics of regional LA reservoir strain. METHODS Fifty patients with paroxysmal atrial fibrillation who underwent computed tomography (CT) and 3D-STE were enrolled. The LA volumes obtained by 3D-STE and CT were compared, and regional LA strain was analyzed. Six LA segments (anterior, septal, inferior, lateral, roof, and posterior) were determined on the basis of LA anatomy. RESULTS In 50 patients (mean age, 64 years; 62% male), the 3D-STE-derived LA volume index (LAVI) showed good correlation with the CT-derived index, (r = 0.78, p < 0.001) with an underestimate bias of 10.5 ± 11.0 ml/m2 (p < 0.001). The lateral LA strain was negatively correlated with LAVI and emptying fraction, while the anterior and septal strains were not. In the 1st quantile LA volume group, the segmental LA strain was heterogeneous, that is, the lateral and inferior strains were greater than the anterior strain. While in the 3rd quantile LA volume group, the lateral and inferior strains were decreased, and there was no regional difference. CONCLUSION LA volume obtained by 3D-STE and CT showed a good correlation. LA segmental analysis by 3D-STE enables early identification of how LA dysfunction affects lateral and inferior LA strains, consistent with anatomical features.
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Affiliation(s)
- Ayako Kuraoka
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Tomoko Ishizu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
| | - Miho Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Miyako Igarashi
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Kimi Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Masayoshi Yamamoto
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Tomoko Machino-Ohtsuka
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
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Lei C, Zhu X, Hsi DH, Wang J, Zuo L, Ta S, Yang Q, Xu L, Zhao X, Wang Y, Sun S, Liu L. Predictors of cardiac involvement and survival in patients with primary systemic light-chain amyloidosis: roles of the clinical, chemical, and 3-D speckle tracking echocardiography parameters. BMC Cardiovasc Disord 2021; 21:43. [PMID: 33478398 PMCID: PMC7819214 DOI: 10.1186/s12872-021-01856-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 01/06/2021] [Indexed: 02/08/2023] Open
Abstract
Background Light-chain (AL) amyloidosis is the most common type of systemic amyloidosis with poor prognosis. Currently, the predictors of cardiac involvement and prognostic staging systems are primarily based on conventional echocardiography and serological biomarkers. We used three-dimensional speckle tracking echocardiography (STE-3D) measurements of strain, hypothesizing that it could detect cardiac involvement and aid in prediction of mortality. Methods We retrospectively analysed 74 consecutive patients with biopsy-proven AL amyloidosis. Among them, 42 showed possible cardiac involvement and 32 without cardiac involvement. LV global longitudinal strain (GLS), global radial strain, global circumferential strain and global area strain (GAS) measurements were obtained. Results The GLS and GAS were considered significant predictors of cardiac involvement. The cut-off values discriminating cardiac involvement were 16.10% for GLS, 32.95% for GAS. During the median follow-up of 12.5 months (interquartile range 4–25 months), 20 (27%) patients died. For the Cox proportional model survival analysis, heart rate, cardiac troponin T, NT-proBNP levels, E/e’, GLS, and GAS were univariate predictors of death. Multivariate Cox model showed that GLS ≤ 14.78% and cardiac troponin T ≥ 0.049 mg/l levels were independent predictors of survival. Conclusions STE-3D measurements of LV myocardial mechanics could detect cardiac involvement in patients with AL amyloidosis; GLS and cardiac biomarkers can provided prognostic information for mortality prediction.
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Affiliation(s)
- Changhui Lei
- Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Xi'an, China
| | - Xiaoli Zhu
- Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Xi'an, China
| | - David H Hsi
- Department of Cardiology, Heart and Vascular Institute, Stamford Hospital, Stamford, CT, USA
| | - Jing Wang
- Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Xi'an, China
| | - Lei Zuo
- Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Xi'an, China
| | - Shengjun Ta
- Department of Ultrasound, Yan'an Hospital, Yan'an, Shannxi, China
| | - Qianli Yang
- Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Xi'an, China
| | - Lei Xu
- Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Xi'an, China
| | - Xueli Zhao
- Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Xi'an, China
| | - Yan Wang
- Department of Nephrology, XiJing Hospital, Xi'an, Shannxi, China
| | - Shiren Sun
- Department of Nephrology, XiJing Hospital, Xi'an, Shannxi, China.
| | - Liwen Liu
- Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Xi'an, China.
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Capotosto L, D'Ettorre G, Ajassa C, Cavallari N, Ciardi MR, Placanica G, Ricci S, Lucchetti P, Tanzilli G, Mangieri E, Gaudio C, Vullo V, Vitarelli A. Assessment of Biventricular Function by Three-Dimensional Speckle Tracking Echocardiography in Adolescents and Young Adults with Human Immunodeficiency Virus Infection: A Pilot Study. Cardiology 2019; 144:101-111. [PMID: 31614346 DOI: 10.1159/000503140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 09/03/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The purpose of the study was to assess biventricular parameters of wall deformation with three-dimensional speckle tracking echocardiography (3DSTE) in adolescents and young adults with human immunodeficiency virus (HIV) infection on antiretroviral therapy in order to detect a possible subclinical myocardial dysfunction. METHODS Twenty-one patients aged 12-39 years with HIV, 21 normal controls of the same age and sex, and 21 patients with idiopathic nonischemic dilated cardiomyopathy (DCM) were studied with 3DSTE. All HIV patients were stable in terms of HIV infection, with no history of heart disease or other chronic systemic disease except HIV infection, and were on highly active antiretroviral therapy with good immunological control. Standard echocardiographic measures of left ventricular (LV)-right ventricular (RV) function were assessed. 3D LV global longitudinal strain (GLS), circumferential strain, radial strain, and LV twist were calculated. Global area strain (GAS) was calculated by 3DSTE as percentage variation in surface area defined by the longitudinal and circumferential strain vectors. 3D RV global and free-wall longitudinal strain (FWLS) were obtained. RESULTS LV GLS and GAS were lower in HIV patients compared to normal controls (p = 0.002, and p = 0.01, respectively). There were no significant differences in LV ejection fractions between the groups. There was a weak positive correlation between LV GLS and age (r = 0.215, p = 0.034) and a weak negative correlation between LV GLS and nadir-CD4 T-cells count (r = 0.198, p = 0.043). DCM patients had more marked and widespread reduction in LV GLS and GAS compared to controls (p < 0.001), whereas in HIV patients LV strain impairment (p < 0.05) was more localized in basal and apical regions. RV FWLS was significantly reduced in HIV patients when compared with the control group (p = 0.03). No patient had pulmonary systolic pressure higher than 35 mm Hg. CONCLUSIONS 3DSTE may help to identify HIV patients at high cardiovascular risk allowing early detection of biventricular dysfunction in the presence of normal LV ejection fraction and in the absence of pulmonary hypertension. LV strain impairment in HIV patients is less prominent and widespread compared to DCM patients.
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Affiliation(s)
| | | | - Camilla Ajassa
- Department of Infectious Diseases, Sapienza University, Rome, Italy
| | - Nelson Cavallari
- Department of Infectious Diseases, Sapienza University, Rome, Italy
| | | | | | - Serafino Ricci
- Department of Infectious Diseases, Sapienza University, Rome, Italy
| | - Pietro Lucchetti
- Department of Infectious Diseases, Sapienza University, Rome, Italy
| | | | | | - Carlo Gaudio
- Department of Cardiology, Sapienza University, Rome, Italy
| | - Vincenzo Vullo
- Department of Infectious Diseases, Sapienza University, Rome, Italy
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Zhong Y, Bai W, Xie Q, Sun J, Tang H, Rao L. Cardiac function in patients with polymyositis or dermatomyositis: a three-dimensional speckle-tracking echocardiography study. Int J Cardiovasc Imaging 2018; 34:683-93. [PMID: 29168054 DOI: 10.1007/s10554-017-1278-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 11/13/2017] [Indexed: 02/05/2023]
Abstract
Cardiac event is a major cause of death in patients with idiopathic inflammatory myopathies (IIM). The most frequent IIMs are polymyositis (PM) and dermatomyositis (DM). The purpose of this study was to analyze cardiac involvement by three-dimensional speckle-tracking echocardiography (3D STE) in patients with PM or DM, and to identify the relationship of cardiac injury with clinical characteristics and disease-specific parameters. 60 PM/DM patients with preserved left ventricular ejection fraction and 30 matched healthy controls were assessed by conventional echocardiography, 3D STE with biventricular strain analysis and electrocardiogram. Compared to controls, patients with PM/DM had significantly diminished left ventricular global longitudinal systolic strain and right ventricular longitudinal systolic strain (LVGLS, - 20.3 ± 2.5 vs. - 23.4 ± 1.7%; RVLS, - 19.4 ± 4.2 vs - 24.8 ± 2.0%; both P < 0.001), and longer QTc intervals(421.0 ± 38.4 vs 400.6 ± 14.5 ms, P = 0.001). Multiple regression analysis showed that Myositis Damage Index (MDI) was independently associated with LVGLS (R2 = 0.44, P = 0.002) and RVLS (R2 = 0.56, P < 0.001) in PM/DM patients with established disease course more than 1 year. In multivariate analysis of pooled data for all the PM/DM patients, when MDI was excluded due to missing observations, disease duration correlated with worse LVGLS (R2 = 0.24, P = 0.002), while concomitant interstitial lung disease correlated with worse RVLS (R2 = 0.30, P < 0.001). Disease activity scores (Myositis Intention to Treat Activities Index) had a weak positive correlation with QTc intervals (rsp = 0.31, P = 0.02). Our results suggest that cardiac injury in PM/DM is a long-term process and its severity depends on patients' heterogeneous clinical features and systemic disease burden.
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