AI Article Synopsis
- - The study investigates the prevalence of occult left ventricular diastolic dysfunction (LVDD) in patients with systemic sclerosis (SSc) using exercise tests, finding that about 29% of participants exhibited this condition despite having normal resting heart function.
- - Researchers conducted exercise stress tests and measured hemodynamic parameters, determining that patients with occult LVDD had significantly higher pulmonary artery wedge pressure (PAWP) during exercise compared to those without LVDD.
- - The findings suggest that a higher PAWP after a leg raise could be an effective marker for identifying occult LVDD in SSc patients, indicating a need for further investigation in this area.
Article Abstract
Despite the poor prognosis of systemic sclerosis (SSc) due to the co-occurrence of left ventricular diastolic dysfunction (LVDD), presence of occult LVDD has not been sufficiently investigated. This retrospective study aimed to reveal the prevalence and determinants of occult LVDD in patients with SSc by exercise stress test. Forty-five SSc patients (age, 63 ± 13 years; men/women, 6/39) with normal pulmonary artery pressure and pulmonary artery wedge pressure (PAWP) at rest underwent a symptom-limited exercise test with right heart catheterization using a supine cycle ergometer; haemodynamic parameters at rest, leg raise and during exercise were evaluated. Occult LVDD defined PAWP ≥ 25 mmHg during exercise was seen in 13 patients (29%). Higher PAWP, lower pulmonary vascular resistance and diastolic pulmonary pressure gradient, larger left atrium at rest, and higher PAWP during leg raise (15 ± 4 vs 10 ± 4 mmHg in non-LVDD group, p < 0.001) were observed in the occult LVDD group. The area under the ROC curve for PAWP after leg raise was largest at 0.83 (95% CI: 0.70-0.95, p = 0.001). About one-third (29%) of SSc patients with normal haemodynamics at rest showed occult LVDD. A higher PAWP after leg raise could be useful for detecting occult LVDD.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8844378 | PMC |
| http://dx.doi.org/10.1038/s41598-022-06400-7 | DOI Listing |
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