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Cardiac involvement in undifferentiated connective tissue disease at risk for systemic sclerosis (otherwise referred to as very early–early systemic sclerosis): a TDI study

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Abstract

Undifferentiated connective tissue disease at risk for systemic sclerosis (UCTD-risk-SSc), otherwise referred to as very early–early SSc, is a condition characterized by Raynaud’s phenomenon with serum SSc marker autoantibodies and/or typical capillaroscopic findings and unsatisfying classification criteria for the disease. The aim of the present study was to assess the prevalence of right (RV) or left ventricular (LV) systolic and/or diastolic dysfunction by standard echocardiography and tissue Doppler imaging (TDI). Thirty patients with UCTD-risk-SSc (28 female, mean age 47 ± 13 years, range 21–70) and 30 age- and sex-matched controls underwent cardiac assessment by standard echocardiography and TDI. UCTD-risk-SSc patients and controls did not show any difference at standard echocardiography. Despite results falling within the respective normal ranges, TDI pointed out a mild impairment of LV and RV diastolic (E m 15 ± 4 vs. 19 ± 5, p = 0.0004; E/E m 6.1 ± 1.7 vs. 4.8 ± 1.2, p = 0.001; E t 14 ± 3 vs. 16 ± 2, p = 0.02; E t/A t 0.9 ± 0.4 vs. 1.3 ± 0.3, p = 0.002; E/E t 3.5 ± 1.2 vs. 4.2 ± 0.9, p = 0.02) and systolic function (S m 13 ± 3 vs. 15 ± 2 cm/s, p < 0.0003; S t 14 ± 2 vs. 16 ± 3 cm/s, p < 0.0001) and increased estimated pulmonary artery wedge pressure (9 ± 2 vs. 8 ± 1, p = 0.001) in UCTD-risk-SSc patients as compared to controls. Notably, a statistically significant difference also emerged in the prevalence of TDI detected E′/A′t, (71% of UCTD-risk-SSc patients vs. 19% of controls; p < 0.0001). Our study shows that UCTD-risk-SSc patients show a previously unrecognized, mild biventricular systolic and diastolic dysfunction as compared to controls. The pathophysiologic meaning as well the predictive value of developing overt SSc await to be elucidated.

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Authors and Affiliations

  1. Department of Cardiology, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Michele D’Alto, Paola Argiento, Emanuele Romeo, Agostino Mattera Iacono, Antonello D’Andrea & Maria Giovanna Russo

  2. Rheumatology Unit, Department of Internal and Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Antonella Riccardi, Ilaria Di Stefano, Serena Fasano & Gabriele Valentini

  3. Department of Clinical Medicine and Surgery, Medical School, University “Federico II”, Naples, Italy

    Alessandro Sanduzzi & Marialuisa Bocchino

  4. Division of General and Bariatric Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Ludovico Docimo & Salvatore Tolone

Authors
  1. Michele D’Alto
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  2. Antonella Riccardi
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  3. Paola Argiento
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  4. Ilaria Di Stefano
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  5. Emanuele Romeo
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  6. Agostino Mattera Iacono
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  7. Antonello D’Andrea
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  8. Serena Fasano
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  10. Marialuisa Bocchino
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  11. Ludovico Docimo
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  12. Salvatore Tolone
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  13. Maria Giovanna Russo
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  14. Gabriele Valentini
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Corresponding author

Correspondence to Gabriele Valentini.

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The authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by Ethical Committee of University of Campania “Luigi Vanvitelli” (protocol number 709).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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D’Alto, M., Riccardi, A., Argiento, P. et al. Cardiac involvement in undifferentiated connective tissue disease at risk for systemic sclerosis (otherwise referred to as very early–early systemic sclerosis): a TDI study. Clin Exp Med 18, 237–243 (2018). https://doi.org/10.1007/s10238-017-0477-y

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  • DOI: https://doi.org/10.1007/s10238-017-0477-y

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