Objectives Systemic Sclerosis (SSc) is characterized by widespread microangiopathy and fibrosis of skin and visceral organs. Left ventricle involvement is usually subclinical, characterized by systolic and/or diastolic dysfunction. The global longitudinal strain (GLS), a validated and reliable technique for the measurement of ventricular longitudinal deformation by means of echocardiography, may detect subclinical systolic dysfunction of SSc myocardium. The improvement of myocardial perfusion by means of intravenous Iloprost administration could ameliorate the contractility of SSc heart. Therefore, we aimed to evaluate GLS in a series of SSc patients prior and after Iloprost infusion. Methods Fifteen consecutive SSc patients (age: 54 ± 11 years; 12 females) treated with Iloprost because of the presence/history of digital ulcers underwent echocardiography, including GLS technique. This evaluation was conducted immediately before Iloprost administration and at the end of the 6-h infusion session. Results Significant improvement in the mean GLS was observed after Iloprost administration (from -13.5 ± 2.5 to -15 ± 3.3; p= 0.011). The echocardiographic data obtained from the four-chamber view showed the best quality for GLS analysis and showed a highly significant improvement of the strain after Iloprost administration (from -13.4 ± 2.2 to -15.6 ± 3; p= 0.001). The degree of GLS improvement did not correlate with any SSc parameters. Conclusion Iloprost administration improved GLS, suggesting that the increase of myocardial perfusion allowed, at least in part, a correction of left ventricular systolic dysfunction. Further studies are needed to confirm these findings, further exploring the mid/long-term effects of Iloprost on myocardial contraction.

中文翻译：

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接受伊洛前列素治疗的系统性硬化症患者心脏纵向应变率变化的评估：一项观察性研究


目标 系统性硬化症 (SSc) 的特点是广泛的微血管病变以及皮肤和内脏器官的纤维化。左心室受累通常是亚临床的，其特征是收缩和/或舒张功能障碍。整体纵向应变 (GLS) 是一种通过超声心动图测量心室纵向变形的有效且可靠的技术，可以检测 SSc 心肌的亚临床收缩功能障碍。静脉注射伊洛前列素改善心肌灌注可改善SSc心脏的收缩力。因此，我们旨在评估一系列 SSc 患者输注伊洛前列素之前和之后的 GLS。方法 连续 15 名因手指溃疡的存在/病史而接受伊洛前列素治疗的 SSc 患者（年龄：54 ± 11 岁；12 名女性）接受超声心动图检查，包括 GLS 技术。该评估是在伊洛前列素给药之前和 6 小时输注结束时立即进行的。结果 服用伊洛前列素后观察到平均 GLS 显着改善（从 -13.5 ± 2.5 至 -15 ± 3.3；p= 0.011）。从四腔切面获得的超声心动图数据显示 GLS 分析的最佳质量，并显示伊洛前列素给药后应变有非常显着的改善（从 -13.4 ± 2.2 到 -15.6 ± 3；p= 0.001）。 GLS 改善程度与任何 SSc 参数均不相关。结论 伊洛前列素给药改善了 GLS，表明心肌灌注的增加至少部分地纠正了左心室收缩功能障碍。需要进一步的研究来证实这些发现，进一步探讨伊洛前列素对心肌收缩的中/长期影响。