Abstract:
To measure left ventricular (LV) global longitudinal strain (GLS) using speckle tracking echocardiography in idiopathic inflammatory myopathy (IIM) patients and to determine whether the LV GLS predicts outcomes in those patients. Prospective study consisted of a cross-sectional phase with 61 IIM patients and 32 individuals without IIM and longitudinal phase, in which patients were divided into two subgroups: 26 with reduced LV GLS and 35 with normal LV GLS; patients were followed for a mean of 25 months, and the occurrence of cardiovascular events and criteria for IIM activity were compared. The mean LV GLS (18.5 ± 2.9% vs. 21.6 ± 2.5%; p < 0.001) and right ventricle free wall strain (21.9 ± 6.1% vs. 27.5 ± 4.7%; p < 0.001) were lower in patients than in controls. The mean N-terminal pro B-type natriuretic peptide level was higher in patients than in controls. There were no differences regarding other cardiac involvement. Anti-Jo1 antibody was associated with general electrocardiographic abnormality and LV diastolic dysfunction. The subgroup with reduced GLS progressed with higher mean creatine phosphokinase, myositis disease activity assessment visual analogue scales, the physician\'s and patient\'s visual analogue scales, the health assessment questionnaire, and a higher proportion of relapses than the subgroup with normal GLS. There was no difference between the subgroups regarding cardiovascular events. The LV GLS appears to be useful for evaluating patients with IIM. Abnormal values are associated with more frequent relapses and increased disease activity during follow-up.
摘要:
在特发性炎症性肌病(IIM)患者中使用斑点追踪超声心动图测量左心室(LV)整体纵向应变(GLS),并确定LVGLS是否可预测这些患者的预后。前瞻性研究包括61例IIM患者和32例无IIM患者的横截面阶段和纵向阶段,其中患者分为两个亚组:26例LVGLS降低,35例LVGLS正常;患者平均随访25个月,比较了心血管事件的发生情况和IIM活性标准。平均LVGLS(18.5±2.9%vs.21.6±2.5%;p<0.001)和右心室游离壁应变(21.9±6.1%vs.27.5±4.7%;p<0.001)患者低于对照组。患者的平均N末端B型利钠肽前体水平高于对照组。在其他心脏受累方面没有差异。抗Jo1抗体与一般心电图异常和左心室舒张功能障碍有关。GLS降低的亚组进展为较高的平均肌酸磷酸激酶,肌炎疾病活动评估视觉模拟量表,医生和病人的视觉模拟量表,健康评估问卷,复发比例高于GLS正常的亚组。在心血管事件方面,亚组之间没有差异。LVGLS似乎可用于评估IIM患者。异常值与随访期间更频繁的复发和增加的疾病活动性相关。