Atrial function follow-up in treated patients with systemic sclerosis

Background: Cardiac involvement in scleroderma (SSc) includes myocardial fibrosis, with consequent diastolic dysfunction. Left atrial (LA) remodelling is frequently an early sign of diastolic dysfunction.
Objective: To assess 2D speckle tracking echocardio-graphy parameters of atrial function, in patients with different forms of SSc and to determine their long term evolution under standard therapy.
Methods: 60 subjects with SSc were studied at baseline. Of those, 52 were reassessed after 1 year and 30 after 2 years of treatment. Standard 2D echocardiography was used for left and right atrial volumes. Speckle tracking was used to determine left and right peak positive and negative strain (LAPPS, LAPNS, RAPPS, RAPNS) and global strain (LAGS, RAGS).
Results: At baseline, standard echo parameters were normal (LA indexed volume 22.3±5.3 ml; RA indexed volume 18.6±7.0 ml). After 1 year and similarly after 2 years of treatment, speckle tracking echo parameters, were similar to baseline, with no correlation to the treat-ment type (LAPPS% 13.5±5.1 at baseline vs. 13.7±5.7 at 1 year and 11.7±8.4 at 2 years; LAPNS% -13.8±4.1 vs. -12.5±3.8 and -11.6±4.5; LAGS% 34.3±4.4 vs. 26.2±6.7 and 23.9±8.0; RAPPS% 14.4±7.5 vs. 13.0±6.8 and 14.7±8.1; RAPNS% -16.6±5.7 vs. -16.6±6.3 and -16.4±4.4; RAGS% 31.04±9.3 vs. 29.5±8.3 and 31.7±7.8, for all parameters p=NS).
Conclusions: Patients with SSc have normal atrial function, maintaining stable under standard therapy. Longer follow up and correlation with ventricular dias-tolic function is needed.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)