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FRI0378 Cardiac involvement in undifferentiated connective tissue disease at risk for systemic sclerosis. a tissue doppler imaging study
  1. A Riccardi1,
  2. M D'Alto2,
  3. P Argiento2,
  4. E Romeo2,
  5. I Di Stefano1,
  6. S Fasano1,
  7. A Mattera Iacono2,
  8. A D'Andrea2,
  9. A Sanduzzi3,
  10. M Bocchino3,
  11. L Docimo4,
  12. S Tolone4,
  13. MG Russo2,
  14. G Valentini1
  1. 1Rheumatology Unit
  2. 2Department of Cardiology, University of Campania “Luigi Vanvitelli”
  3. 3Department of Clinical Medicine and Surgery, University “Federico II”
  4. 4Division of General and Bariatric Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

Abstract

Background Undifferentiated connective tissue disease at risk for Systemic Sclerosis (UCTD-risk-SSc), previously referred to as very early SSc, is a condition characterized by Raynaud's phenomenon (RP) with SSc marker autoantibodies and/or typical capillaroscopic findings and unsatisfying classification criteria for the disease (1). UCTD-risk- SSc patients have been reported to present, in about 40% of the cases, a preclinical vascular internal organ disease as detected by a diffusing lung capacity for CO <80% of the predicted value (lung involvement) and/or a low esophageal sphincter pressure <15 mmHg (oesophageal involvement) and/or a mitral E/A ratio <1 (heart involvement) (2, 3).

Objectives Aim of the present study was to assess the prevalence of right (RV) or left ventricle (LV) systolic and/or diastolic dysfunction by standard echocardiography and tissue Doppler imaging (TDI).

Methods Thirty patients with UCTD-risk-SSc (28 female, aged 47±13 years, range 21–70) and 30 age- and sex-matched controls underwent cardiac assessment by standard echocardiography and TDI.

Results UCTD-risk-SSc patients and controls did not show any difference at standard echocardiographic evaluation. In particular, an inverted E/A ratio was pointed out in 10/30 patients and 7/30 controls (p=ns). TDI showed a mild impairment of LV and RV diastolic (Em15±4 vs 19±5, p<0.0001;E/Em 6.1±1.7 vs 4.8±1.2, p=0.001; Et 14±3 vs 16±2, p=0.02; Et/At0.9±0.4 vs 1.3±0.3, p<0.002; increased pulmonary artery wedge pressure 9±2 vs 8±1, p=0.001)and systolic function (Sm 13±3 vs 15±2 cm/sec, p<0.0003; St 14±2 vs 16±3 cm/sec, p<0.0001) in UCTD- risk-SSc patients in comparison to controls.

Conclusions Our study shows that UCTD-risk-SSc patients present a previously unrecognized, mild biventricular systolic and diastolic dysfunction as compared to controls. The pathophysiologic meaning (i.e.intramyocardial artery disease and/or patchy fibrosis) as well the predictive value of developing overt SScin the short time await to be elucidated.

Disclosure of Interest None declared

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