Abstract 15107: Increase in Ventricular Stiffness in Patients with Systemic Autoimmune Disease without Accompanied Ventricular Concentric Remodeling
Background: Remodeling is the accepted cause of left ventricular (LV) stiffness which contributes to myocardial diastolic dysfunction. The aim of this study was to determine whether early remodeling plays a role in ventricular stiffness (elastance) changes in patients with systemic autoimmune but without cardiovascular diseases.
Methods: Ninety-one patients with psoriasis arthritis (PsA), 81 patients with systemic lupus erythematosus (SLE) and 134 controls, who had no clinical evidence of cardiovascular diseases, underwent conventional echocardiography and tissue Doppler imaging. Those with hypertension and/or LV hypertrophy were excluded. As a result, 49 patients with PsA, 37 with SLE and 75 controls were enrolled. To evaluate LV stiffness and subclinical diastolic dysfunction, the ratio of the mitral inflow early diastolic filling velocity (E) to the peak early diastolic velocity at lateral mitral annular (E’) was measured. LV diastolic elastance, a marker of stiffness, was estimated as E/E’ divided by LV stroke volume. Subclinical LV diastolic dysfunction was identified by E’ <11.5cm/s and/or E/E’ >10.
Results: Age, blood pressure and LV mass index were comparable among three groups. In both patients groups with SLE and PsA, LV elastance was increased significantly (p<0.001), which was associated with a higher prevalence of LV diastolic dysfunction (p=0.012) (Table). Intriguingly, only the SLE group had increase in prevalence of LV concentric remodeling (p<0.001), but not those with PsA. Furthermore, ventricular diastolic stiffness was correlated with PSA (r=0.350, p=0.021) and SLE duration (r=0.375, p=0.022).
Conclusions: As patients with PsA had increased in ventricular stiffness without accompanied concentric remodeling, this suggests that other factors might have played a role in patients with systemic autoimmune disease which warrant further studies.
- © 2011 by American Heart Association, Inc.