Left and Right Ventricular Functional Status in Patients Suffering From Scleroderma With Normal Pulmonary Arterial Pressure

Background: The occurrence of cardiac structural and functional abnormalities in patients with scleroderma and pulmonary arterial hypertension has been clearly assessed; there are, however, only a few studies on cardiac manifestations in patients with normal pulmonary arterial pressure, which is the purpose of this study. Methods: In this case-control study, 35 patients with known systemic sclerosis referred to the Systemic Sclerosis Clinic of Shariati Hospital in 2018 were selected. From among individuals without systemic sclerosis that had referred only for routine clinical check-ups, 35 patients were selected as the control group. All the subjects were assessed by 2D echocardiography, tissue Doppler imaging, and speckle-tracking echocardiography. Results: Compared with the healthy control group, significant changes were observed in the left atrium, the aortic root, the interventricular septum diastolic thickness, the posterior wall diastolic thickness, the right ventricular diameter, and the right ventricular systolic motion in the patients with scleroderma. Additionally, the changes in left ventricular global circumferential strain and right ventricular global longitudinal strain in the apical 4-chamber view parameters were significant in these patients, although there was no difference between the 2 groups in terms of the left ventricular global longitudinal strain index. In the patients with scleroderma and normal pulmonary arterial pressure, there was a significant direct correlation between the age of the patients with the pulmonary artery size and an inverse correlation between age and E' septal and E' lateral. Conclusions: Patients with scleroderma or systemic sclerosis suffer systolic and diastolic dysfunction, which can be associated with significant atrial/ventricular structural and functional changes. These changes may be independent of pulmonary arterial pressure, but the risk of these abnormalities will be increased in advanced age.