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- W4313443606 abstract "The long-term survival of pulmonary arterial hypertension related to scleroderma (PAH-Ssc) remains behind others PAH forms. Because earlier diagnosis translates into better prognosis, we hypothesize that exercise echocardiography and speckle tracking analysis could improve PAH-Ssc screening performance. To evaluate the interest of exercise echocardiography and speckle tracking analysis for PAH-Ssc screening. High-risk scleroderma patients, based on DETECT algorithm, were prospectively included. All the patients underwent transthoracic echocardiography (including strain analysis) and right heart catheterization both at rest and at peak exercise. The outcome was the presence of PAH at rest, defined by a mPAP ≥ 20 mmHg, PAWP < 15 mmHg and PVR ≥ 3 WU. Multivariable logistic regression analysis was used to identify variables associated with the outcome and ROC curves for the associated thresholds. Fifty-five scleroderma patients were included: n = 22 with PAH, n = 33 without PAH. Median age was 62 yo, 89% of female. They were no differences in term of demographic, scleroderma and clinical features in the two groups. At rest, TAPSE/sPAP ratio was independently associated with PAH whereas at exercise, peak right atrial (RA) strain and right ventricular fractional area change (RV FAC) were independently associated with the outcome. ROC curves identified the following associated thresholds: TAPSE/sPAP < 0.50 mm/mmHg at rest, RV FAC < 47% and peak RA strain < 36% at exercise. The presence of RV FAC ≥ 47% and peak RA strain ≥ 36% at exercise had a 100% sensitivity and 100% negative predictive value to exclude PAH, outperforming actual ESC/ERS guidelines. Speckle tracking and exercise echocardiography, using RV FAC < 47% and peak RA strain < 36% at exercise may improve PAH-Ssc screening capacity, translating into earlier management and better outcome." @default.
- W4313443606 created "2023-01-06" @default.
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- W4313443606 date "2023-01-01" @default.
- W4313443606 modified "2023-09-26" @default.
- W4313443606 title "Exercise echocardiography and speckle tracking interest to unmask pulmonary arterial hypertension in scleroderma patients" @default.
- W4313443606 doi "https://doi.org/10.1016/j.acvdsp.2022.10.131" @default.
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