Detecting early myocardial involvement in systemic sclerosis using cardiac magnetic resonance T1 mapping and speckle tracking echocardiography in correlation with plasma concentration of C-terminal pro-endothelin-1

Cardiologia CROATICA Background: Systemic sclerosis (Ssc) leads to progressive myocardial fibrosis and subsequent alteration in function. Cardiac magnetic resonance (CMR) T1-mapping and speckle tracking echocardiography (STE) are two recent modalities able to quantify diffuse fibrosis and deformation, respectively. We aimed to determine whether these methods could detect left ventricular (LV) dysfunction at an early stage of SSc, and whether there was a relationship between myocardial alteration and plasma levels of C-terminal pro-endothelin-1 (CT-proET-1). Methods: 54 consecutive SSc patients with normal conventional echocardiography and no CMR late gadolinium enhancement, and 16 healthy controls underwent CMR T1mapping and STE. CT-proET-1 was measured in 35 patients. Results: As compared with the controls, SSc patients had shorter global (354 ±23 ms vs. 367 ±23, P=0.04) and basal inferoseptal LV post-contrast T1 values (336 ±22 ms vs. 353 ±24, P=0.01). In addition, basal inferoseptal segment in SSc patients showed decreased longitudinal peak systolic strain as compared with controls (-16.3 ±4% vs -19.6 ±4%, P=0.009). T1 value correlated with parameters of longitudinal function (P<0.001). Finally, CT-proET-1 level was higher in patients with shorter T1 value (78 ±8 vs.52 ±3 pmol/L, P=0.03) and correlated with peak early diastolic strain rate (r=0.51, P=0.002) within the basal inferoseptal segment.