In juvenile dermatomyositis, cardiac systolic dysfunction is present after long-term follow-up and is predicted by sustained early skin activity.
Ann Rheum Dis
; 73(10): 1805-10, 2014 Oct.
Article
en En
| MEDLINE
| ID: mdl-23881732
ABSTRACT
OBJECTIVE:
To compare systolic cardiac function in patients with juvenile dermatomyositis (JDM) with matched controls and examine associations between systolic and diastolic cardiac function and disease variables.METHODS:
Fifty-nine patients, examined at follow-up, median 16.8â years (2-38â years) after disease onset, were compared with 59 age-matched and sex-matched controls. Echocardiography was performed and analysed blinded to patient information. We used mitral annulus displacement to assess the relative long-axis shortening of the left ventricle (long-axis strain) and early diastolic tissue velocity (e'), as markers for systolic and diastolic function, respectively. Disease activity and organ damage were assessed at follow-up by clinical examination and retrospectively by chart review.RESULTS:
Long-axis strain was reduced in patients compared with controls (16.6% (2.5) vs 17.7% (2.0), mean (SD), p=0.001), whereas no difference was seen between patients with active and inactive disease. Disease duration correlated with systolic and diastolic function (rsp=-0.50 and rsp=-0.73, both p<0.001) and so did Myositis Damage Index (MDI) 1â year (rsp=-0.36 and rsp=-0.46) and MDI at follow-up (rsp=-0.33 and rsp=-0.60), all p<0.01. High early disease activity score (DAS) in skin (DAS skin 1â year), but not in muscle, predicted systolic (standardised ß=-0.28, p=0.011, R(2)=48%) and diastolic dysfunction (ß=-0.36, p<0.001, R(2)=72%) at follow-up.CONCLUSIONS:
Long-axis strain was reduced in JDM patients compared with controls, suggesting systolic dysfunction. Impaired systolic and diastolic function was predicted by DAS skin 1â year. This indicates a common pathway to two different cardiac manifestations in JDM, perhaps with similar pathogenesis as skin affection.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Disfunción Ventricular Izquierda
/
Dermatomiositis
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Child
/
Humans
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Ann Rheum Dis
Año:
2014
Tipo del documento:
Article
País de afiliación:
Noruega