P1001Left ventricular stiffness and subclinical diastolic dysfunction in patients with systemic autoimmune inflammatory diseases


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Abstract

Purpose: Hypertension and left ventricular hypertrophy (LVH) are the common risk factors of diastolic dysfunction by contributing to ventricular stiffness (elastance). The aims of this study were to evaluate the ventricular stiffness and subclinical myocardial dysfunction in patients with systemic autoimmune inflammatory diseases without cardiovascular diseases, especially hypertension or LVH.Methods: One hundred and seventy-two patients with systemic autoimmune inflammatory diseases, who had no clinical evidence of cardiovascular diseases, underwent conventional echocardiography and tissue Doppler imaging. Patients with coexisting hypertension and/or LVH were excluded. Finally, 86 patients (49 with psoriasis arthritis and 37 with systemic lupus erythematosus) and 75 healthy subjects were enrolled. To estimate 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 was estimated as E/E' divided by LV stroke volume. Subclinical LV diastolic dysfunction was defined as E' <11.5cm/s and/or E/E' >10.Results: Age, gender, blood pressure, total arterial compliance, LV mass index and ejection fraction were matched between patient and control groups. However, LV diastolic elastance (p<0.001) and prevalence of subclinical LV diastolic dysfunction (p=0.003) were significantly higher in patients with systemic autoimmune inflammatory disease than those in controls (Table).Conclusions: Patients with systemic autoimmune diseases presented with increased ventricular stiffness and early impairments of diastolic function even if they have no cardiovascular diseases, which suggested inflammation may contribute to early cardiac involvements in such patients.

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