Comparative study of left ventricular function in a group of asymptomatic patients with systemic sclerosis and a controls group

Introduction:. cardiac involvement in systemic sclerosis (SSc) and represents a major cause of morbidity and mortality and constitue an evolutionary turning turnpoint in this disease. Purpose of the work was to describe echocardiographic data in asymptomatic patients with SSc and compare them to results obtained in a control population in order to unmask subclinical cardiac involvement during systemic sclerosis. Methods: Prospective study conducted between 2012 and 2017. Including 2 groups: Group A included 25 asymptomatic scleroderma patients without other comorbidities, Group B consisted of 25 control and healthy subjects. The two groups were explored by echocardiography coupled to tissue Doppler and 2Dstrain . Results: The mean age of our patients was 45 ± 7 years. The sex ratio was 0.8 The control population was on the characteristic epidemiological similar to the group of patients. The anatomical data of the left ventricle (, the ejection fraction normal and comparable between the two groups, the TEI index was significantly higher in the A group (0.8 ± 0.04 vs 0.28 ± 0.07 ,p < 0.01) . Tissue Doppler velocity S peak measurement was reduced in group A compared to group B (5.6 ± 0.5 vs ± 9.30 ± 0.5 , p < 0.01), global longitudinal strain was also altered in scleroderma patients ( -11 ± 0.4 vs -18. ± 0.3 < 0.01). There was no significant difference in E/ A ratio, however early LV diastolic dysfunction was revealed by a higher E / Ea and E/ VP ratioin group A compared to group B with respectively (13 ± 1.8 vs 6 ± 1.6 , p < 0.01) and (2.2 ± 0.6 vs. 1.5± 0.6 p < 0.01), a longer Ap-Am duration (≥ 20ms) and a higher volume of the left atrium was noted in groupe A . The mean value of the pulmonary pressions was 37.9 ± 9 mmHg in patients with scleroderma vs. 25 ± 3 mmHg for the control group (p < 0.01) .There was no right ventricular dysfunction Conclusion: Cardiac involvement during systemic sclerosis precede clinical expression, echocardiography coupled with tissue doppler and 2D strain are useful to detect these abnormalities at a subclinical stage of the disease.