Evaluation of global function of the heart in scleroderma patients

Association between systemic sclerosis and left ventricle dysfunction: Findings from observational studies

Objectives

Cardiac involvement is common in systemic sclerosis (SSc) patients. In this study, we aimed to systematically evaluate the relationship between SSc and left ventricular dysfunction (LVD), especially the left ventricular diastolic dysfunction, by ultrasound and cardiac magnetic resonance data.

Methods

We searched The Cochrane Library, PubMed and Embase databases collected studies about comparing LVD parameters in SSc patients and controls from establishment to January 2022. Furthermore, we also performed a two-sample MR using summary statistics from genome-wide association studies (GWAS) important LVD parameters, including left ventricular end-diastolic volume (LVEDV), left ventricular mass (LVM) and left ventricular ejection fraction (LVEF).

Results

Our meta-analysis included 31 eligible studies with 1448 SSc patients. According to the results, SSc patients had lower peak of early diastolic flow velocity/peak of late diastolic flow velocity ratio (E/A ratio), E, trans-mitral early filling peak velocity (E'), and left ventricular end-diastolic diameter (LVEDD) compared to controls. The E/E' ratio, A, left ventricular isovolumetric relaxation time (IVRT), deceleration Time (DT) and left atrial (LA) diameter were higher in SSc patients in comparison with controls. Moreover, we observed that the SSc patients had lower LVEF than controls. And in MR analysis, we also found that SSc was causally correlated with LVEF (OR = 0.9966, 95% CI 0.9935-0.998, P = 0.0398). However, unfortunately, there was no significant correlation between SSC and LVM (OR = 1.0048, 95% CI 0.9919-1.0179, P = 0.4661) and LVEDV (LVEDV OR = 0.9976, 95%CI 0.9888-1.0066, P = 0.6019).

Conclusion

SSc patients had diastolic/systolic dysfunction. However, MR analysis cannot confirm the genetic relationship between SSc and LVDD because of insufficient data. More research is needed to confirm the causal relationship between the two.

Assessment of left ventricle systolic and diastolic functions in schizophrenia patients

The objective of the study was to scrutinize in detail the changes that occur in left ventricle (LV) systolic and diastolic functions using echocardiography in patients with at least 5 years of history and 40 healthy volunteers matching the patients in age and gender, who were enrolled in a cross-sectional study. All cases were examined with Tei Index, an index that could assess LV systolic and diastolic functions in conjuction, and with LV ejection fraction (LVEF) that assesses systolic function. In addition, Mitral E and A wave velocities, Isovolemic relaxation time (IVRT), Tissue Doppler Em (peak early motion) and Am (peak after motion) waves, which evaluate diastolic functions were measured. Tei Index was calculated as 0.61±0.19 in the patient group, and as 0.39±0.10 in the control group and the difference was statistically significant (p<0.001). LVEF was measured as 58%±5 in the patient group, and as 62%±3 in the control group and the difference was statistically significant (p<0.001). Also the IVRT values were significantly different between the tissue Doppler Em and Em/Am ratio among the groups (p<0.001). Echocardiographic myocardial performance, LV systolic and diastolic functions in schizophrenia patients was found to be worse than those of the control group.