Assessment of Subclinical Cardiac Dysfunction in Diffuse Scleroderma Patients

Objectives: We aimed to evaluate left and right ventric-ular functions with different echocardiographic methods in asymptomatic patients with diffuse scleroderma (SSc). Patients and Methods: Twenty diffuse SSc outpa-tients, asymptomatic with regard to cardiac symptoms and twenty healthy control subjects were enrolled.Conventional left ventricular (LV) and right ventricular (RV) echocardiographic measurements, pulsed wave tissue Doppler imaging (TDI) and myocardial perfor-mance indexes (MPI) were evaluated. Results: Both left (LV early to atrial peak velocity ratio:p 0.02, LV isovolumic relaxation time: p 0.03, LV decelera-tion time: p 0.02) and right ventricle (RV early to atrial peakvelocity ratio: p 0.02) diastolic functions were significantlyreduced in SSc group while the parameters assessing LVsystolic function were similar in both groups. Pulmonaryartery pressure was significantly higher in 25% of SScpatients (31.1±5.2 and 24.7±2.7 mmHg, p 0.001). Althoughmitral and tricuspid annular systolic velocities with TDI (Sm,St) were similar between two groups, obtained diastolicfunctions showed a decrease in SSc patients. Tei index wasstatistically higher in SSc group (left ventricle MPI (LV-MPI):p 0.03 and right ventricle MPI (RV-MPI): p 0.007). Conclusion: Diastolic dysfunction of both ventricleswith different echocardiographic methods was observed in diffuse SSc patients even without cardiac symptoms.