21. Morphological and functional changes of the right ventricle by echocardiography in patients with systemic Lupus erythematosus, scleroderma associated with pulmonary hypertension
Main Article Content
Abstract
Pulmonary hypertension (PH) in autoimmune disease is a factor of poor prognosis and has a more severe effect. Evaluation of morphological and functional changes of the RV has an important role in determining disease progression, treatment and prognosis for autoimmune disease with PH. Our study aimed to evaluate the changes in RV’s morphology and function in patients with SSc and SLE. The study was conducted on 194 patients (132 patients with SLE, 62 patients with SSc) at the Center of Clinical Allergy and Immunology, Bach Mai Hospital and National Institute of Dermatology from August 2016 to August 2020. The results showed that patients with SLE had a compensatory in right ventricular systolic function in the mild PAH class, then gradually decreased with higher PAH class. RV diastolic dysfunction increased in levels of PAH. In patients with SSc, RV systolic function gradually decreased in the subgroups with gradually increasing pulmonary artery pressure, diastolic function tends to be disordered even in the absence of PH.
Article Details
Keywords
Pulmonary hypertension, right ventricle, systemic lupus erythematosus, scleroderma
References
2. Galiè N, Hoeper MM, Humbert M, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). European heart journal. 2009;30(20):2493-2537.
3. Yang X, Mardekian J, Sanders KN, Mychaskiw MA, Thomas J. Prevalence of pulmonary arterial hypertension in patients with connective tissue diseases: a systematic review of the literature. Clinical rheumatology. 2013;32(10):1519-1531.
4. Ruiz-Irastorza G, Garmendia M, Villar I, Egurbide M-V, Aguirre C. Pulmonary hypertension in systemic lupus erythematosus: prevalence, predictors and diagnostic strategy. Autoimmunity reviews. 2013;12(3):410-415.
5. Ngian G-S, Stevens W, Prior D, et al. Predictors of mortality in connective tissue disease-associated pulmonary arterial hypertension: a cohort study. Arthritis research & therapy. 2012;14(5):1-9.
6. Batyraliev T, Ekinsi E, Pataraia S, Pershukov I, Sidorenko B, Preobrazhenskiĭ D. Pulmonary hypertension and right ventricular failure. Part XIV. Differentiated therapy of primary (idiopathic) and associated forms of pulmonary arterial hypertension. Kardiologiia. 2008;48(3):78-84.
7. Bleeker G, Steendijk P, Holman E, et al. Assessing right ventricular function: the role of echocardiography and complementary technologies. Heart. 2006;92(suppl 1):i19-i26.
8. Kalogeropoulos AP, Georgiopoulou VV, Howell S, et al. Evaluation of right intraventricular dyssynchrony by two-dimensional strain echocardiography in patients with pulmonary arterial hypertension. Journal of the American Society of Echocardiography. 2008;21(9):1028-1034.
9. Pirat B, McCulloch ML, Zoghbi WA. Evaluation of global and regional right ventricular systolic function in patients with pulmonary hypertension using a novel speckle tracking method. The American journal of cardiology. 2006;98(5):699-704.
10. Chung L, Liu J, Parsons L, et al. Characterization of connective tissue disease-associated pulmonary arterial hypertension from REVEAL: identifying systemic sclerosis as a unique phenotype. Chest. 2010;138(6):1383-1394.
11. Tuder RM, Abman SH, Braun T, et al. Development and pathology of pulmonary hypertension. Journal of the American College of Cardiology. 2009;54(1_Supplement_S):S3-S9.
12. Luo R, Cui H, Huang D, et al. Early assessment of right ventricular function in systemic lupus erythematosus patients using strain and strain rate imaging. Arquivos brasileiros de cardiologia. 2018;111:75-81.
13. Venkatachalam S, Wu G, Ahmad M. Echocardiographic assessment of the right ventricle in the current era: Application in clinical practice. Echocardiography. 2017;34(12):1930-1947.
14. Schattke S, Knebel F, Grohmann A, et al. Early right ventricular systolic dysfunction in patients with systemic sclerosis without pulmonary hypertension: a Doppler Tissue and Speckle Tracking echocardiography study. Cardiovascular Ultrasound. 2010;8(1):1-9.
15. Matias C, de Isla LP, Vasconcelos M, et al. Speckle-tracking-derived strain and strain-rate analysis: a technique for the evaluation of early alterations in right ventricle systolic function in patients with systemic sclerosis and normal pulmonary artery pressure. Journal of Cardiovascular Medicine. 2009;10(2):129-134.
16. Durmus E, Sunbul M, Tigen K, et al. Right ventricular and atrial functions in systemic sclerosis patients without pulmonary hypertension. Herz. 2015;40(4):709-715.
17. Giunta A, Tirri E, Maione S, et al. Right ventricular diastolic abnormalities in systemic sclerosis. Relation to left ventricular involvement and pulmonary hypertension. Annals of the rheumatic diseases. 2000;59(2):94-98.
18. Ciurzyński M, Bienias P, Irzyk K, et al. Heart diastolic dysfunction in patients with systemic sclerosis. Archives of medical science: AMS. 2014;10(3):445.
19. Lindqvist P, Caidahl K, Neuman-Andersen G, et al. Disturbed right ventricular diastolic function in patients with systemic sclerosis: a Doppler tissue imaging study. Chest. 2005;128(2):755-763.