Association between Left Atrial Function and Survival in Systemic Sclerosis
Journal of Cardiovascular Development and Disease, vol. 11, pp. 310
Abstract
Systemic sclerosis (SSc) is a multisystemic autoimmune disorder in which cardiac involvement is frequent and portends negative prognosis. Left ventricular (LV) diastolic dysfunction is one of the most common cardiac alterations in these patients, and left atrial (LA) reservoir strain (ƐR) measurement using speckle tracking echocardiography has been proposed as a novel parameter for a better assessment of LV diastolic function. Therefore, the aim of this study was to test the prognostic value of ƐR in a large multicenter cohort of SSc patients. In total, 311 SSc patients (54 ± 14 years, 85% female) were included from two different centers. Echocardiography was performed at the time of first visit, including ƐR measurement. Over a median follow-up of 132 (interquartile range: 110 to 157) months, 67 (21.5%) patients experienced the outcome of all-cause mortality. Spline curve analysis identified an optimal cut-off value of 30% for ƐR, and patients with ƐR ≤ 30% showed a 10-year cumulative survival rate of 71% as compared to 88% for patients with ƐR > 30% (log-rank p < 0.001). At the multivariable Cox regression analysis, ƐR was independently associated with the endpoint (HR 1.830; 95% confidence interval (CI) 1.031–3.246; p = 0.039) together with age (HR 1.071, 95% CI 1.043 to 1.099; p < 0.001), sex (female) (HR 0.444, 95% CI 0.229 to 0.861; p = 0.016), and diffusing lung capacity for carbon monoxide (HR 0.969 95% CI 0.956 to 0.982; p < 0.001). ƐR is of independent prognostic value in SSc and might help optimizing risk stratification in these patients.
Authors 14
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Leiden University Medical Center · University of Medicine and Pharmacy of Craiova · Institutul de Urgenţă pentru Boli Cardiovasculare "Prof.Dr. C.C. Iliescu"
Affiliation as printed
Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
Department of Internal Medicine, Craiova University of Medicine and Pharmacy, Petru Rares 2, 200349 Craiova, Romania
“Prof. Dr. C.C. Iliescu” Emergency Institute for Cardiovascular Diseases, Fundeni Street 258, 022328 Bucharest, Romania
"Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, Fundeni Street 258, 022328 Bucharest, Romania
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Vrije Universiteit Brussel · Leiden University Medical Center · Universitair Ziekenhuis Brussel
Affiliation as printed
Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
Department of Cardiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Avenue du Laerbeek 101, 1090 Jette, Brussels, Belgium
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Leiden University Medical Center · Agostino Gemelli University Polyclinic · Istituti di Ricovero e Cura a Carattere Scientifico
Affiliation as printed
Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Via Giuseppe Moscati 31, 00168 Rome, Italy
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Royal Perth Hospital · Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, 197 Wellington Street, Perth, WA 6000, Australia
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Carol Davila University of Medicine and Pharmacy · Institutul de Urgenţă pentru Boli Cardiovasculare "Prof.Dr. C.C. Iliescu"
Affiliation as printed
Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Eroii Sanitari Bvd no. 8, 050474 Bucharest, Romania
“Prof. Dr. C.C. Iliescu” Emergency Institute for Cardiovascular Diseases, Fundeni Street 258, 022328 Bucharest, Romania
"Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, Fundeni Street 258, 022328 Bucharest, Romania
Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Eroii Sanitari Bvd no. 8, 050474 Bucharest, Romania
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Carol Davila University of Medicine and Pharmacy · Institutul de Urgenţă pentru Boli Cardiovasculare "Prof.Dr. C.C. Iliescu"
Affiliation as printed
Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Eroii Sanitari Bvd no. 8, 050474 Bucharest, Romania
“Prof. Dr. C.C. Iliescu” Emergency Institute for Cardiovascular Diseases, Fundeni Street 258, 022328 Bucharest, Romania
"Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, Fundeni Street 258, 022328 Bucharest, Romania
Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Eroii Sanitari Bvd no. 8, 050474 Bucharest, Romania
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Carol Davila University of Medicine and Pharmacy · Spitalul Universitar de Urgență Elias
Affiliation as printed
Department of Gastroenterology and Hepatology, Elias University Emergency Hospital, Marasti Bvd 17, 011461 Bucharest, Romania
Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Eroii Sanitari Bvd no. 8, 050474 Bucharest, Romania
Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Eroii Sanitari Bvd no. 8, 050474 Bucharest, Romania
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Spitalul Universitar de Urgenţă Militar Central Dr. Carol Davila
Affiliation as printed
Department of Internal Medicine, “Carol Davila” Central Military Emergency University Hospital, Calea Plevnei 134, 010825 Bucharest, Romania
Department of Internal Medicine, "Carol Davila" Central Military Emergency University Hospital, Calea Plevnei 134, 010825 Bucharest, Romania
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Carol Davila University of Medicine and Pharmacy
Affiliation as printed
Department of Rheumatology, “Sf. Maria” Clinical Hospital, Ion Mihalache Bvd 37–39, 011172 Bucharest, Romania
Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Eroii Sanitari Bvd no. 8, 050474 Bucharest, Romania
Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Eroii Sanitari Bvd no. 8, 050474 Bucharest, Romania
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University of Medicine and Pharmacy of Craiova
Affiliation as printed
Department of Rheumatology, Craiova University of Medicine and Pharmacy, Petru Rares 2, 200349 Craiova, Romania
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Leiden University Medical Center
Affiliation as printed
Department of Rheumatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Rheumatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
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