We used real time, three-dimensional transthoracic echocardiography (3DTTE) to evaluate left atrial (LA) volume and mechanical function in patients with primary Sjögren's syndrome (SS).

Methods

We prospectively included 42 consecutive patients with primary SS and 42 controls who were similar in terms of basal characteristics. 3DTTE was used to assess LA function.

Results

Maximum LA volume, minimum LA volume, pre-atrial contraction LA volume, LA Active Stroke Volume (ASV), LA Total Stroke Volume (TSV), maximal left atrial volume index (LAVImax), Left atrial pre-contraction volume index, and Left atrial minimum volume index, ASV index, and TSV index were significantly higher in the SS group, and the LA Total Emptying Fraction, LA Expansion Index, and LA Passive Emptying Fraction were significantly lower. Although the active emptying fraction was higher in the SS group, the difference was not statistically significant. LAVImax was positive correlated with disease duration (r = .753).

Conclusion

Left atrial function is impaired in SS patients and serves as an early marker of subclinical cardiac involvement.

CONFLICT OF INTEREST

The authors declare that they have no conflict of interest and any financial disclosures.

REFERENCES

1Tucci M, Quatraro C, Silvestris F. Sjogren's syndrome: an autoimmune disorder with otolaryngological involvement. Acta Otorhinolaryngol Ital. 2005; 25(3): 139–144.
CAS PubMed Google Scholar
2Bayram NA, Cıcek OF, Erten S, et al. Assessment of left ventricular functions in patients with Sjogren's syndrome using tissue doppler echocardiography. Int J Rheum Dis. 2013; 16: 425–429.
10.1111/1756-185X.12049
PubMed Web of Science® Google Scholar
3Vidal E, Delaire L, Berdah JF, et al. Systemic signs of primary Gougerot-Sjogren syndrome. 48 cases. Ann Med Interne. 1994; 145(3): 168–174.
CAS PubMed Google Scholar
4García-Carrasco M, Ramos-Casals M, Rosas J, et al. Primary Sjögren syndrome: clinical and immunologic disease patterns in a cohort of 400 patients. Medicine. 2002; 81(4): 270–280.
10.1097/00005792-200207000-00003
PubMed Web of Science® Google Scholar
5Akyel A, Tavil Y, Tufan A, et al. Atrial electromechanical delay and diastolic dysfunction in primary Sjögren syndrome. Clin Invest Med. 2012; 35(5): 303.
10.25011/cim.v35i5.18703
Web of Science® Google Scholar
6Launay D, Hachulla E, Hatron PY, et al. Pulmonary arterial hypertension: a rare complication of primary Sjögren syndrome: report of 9 new cases and review of the literature. Medicine. 2007; 86(5): 299–315.
10.1097/MD.0b013e3181579781
PubMed Web of Science® Google Scholar
7Ye YC, Zeng Y, Zhu WL, et al. Cardiac manifestations in Sjogren syndrome. Zhonghua Xin Xue Guan Bing Za Zhi. 2008; 36(4): 327–331.
PubMed Google Scholar
8Moller JE, Hillis GS, Oh JK, et al. Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation. 2003; 107(17): 2207–2212.
10.1161/01.CIR.0000066318.21784.43
PubMed Web of Science® Google Scholar
9Bayramoğlu A, Taşolar H, Otlu YÖ, et al. Assessment of left atrial volume and mechanical functions using real-time three-dimensional echocardiography in patients with mitral annular calcification. Anatol J Cardiol. 2016; 16: 42–47.
PubMed Web of Science® Google Scholar
10Mor-Avi V, Yodwut C, Jenkins C, et al. Real-time 3D echocardiographic quantification of left atrial volume: multicenter study for validation with CMR. JACC Cardiovasc Imaging. 2012; 5(8): 769–777.
10.1016/j.jcmg.2012.05.011
PubMed Web of Science® Google Scholar
11Anwar AM, Soliman OI, Geleijnse ML, et al. Assessment of left atrial volume and function by real-time three dimensional echocardiography. Int J Cardiol. 2008; 123(2): 155–161.
10.1016/j.ijcard.2006.12.017
PubMed Web of Science® Google Scholar
12Wu VC, Takeuchi M. Three-dimensional echocardiography: current status and real-life applications. Acta Cardiol Sin. 2017; 33(2): 107–118.
PubMed Web of Science® Google Scholar
13Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sjogren's syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis. 2002; 61(6): 554–558.
10.1136/ard.61.6.554
CAS PubMed Web of Science® Google Scholar
14Devereux RB, Casale PN, Wallerson DC, et al. Cost-effectiveness of echocardiography and electrocardiography for detection of left ventricular hypertrophy in patients with systemic hypertension. Hypertension. 1987; 9(2 Pt 2): II69–II76.
CAS PubMed Web of Science® Google Scholar
15Verbraecken J, Van de Heyning P, De Backer W, et al. Body surface area in normal-weight, overweight, and obese adults. A comparison study. Metabolism. 2006; 55(4): 515–524.
10.1016/j.metabol.2005.11.004
CAS PubMed Web of Science® Google Scholar
16Hidayet Ş, Yağmur J, Bayramoğlu A, et al. Prediction of postoperative atrial fibrillation with left atrial mechanical functions and NT-pro ANP levels after coronary artery bypass surgery: a three-dimensional echocardiography study. Echocardiography. 2018; 35: 661–666.
10.1111/echo.13833
PubMed Web of Science® Google Scholar
17Ikonomidis I, Lekakis J, Stamatelopoulos K, et al. Aortic elastic properties and left ventricular diastolic function in patients with Adamantiades-Behcet's disease. J Am Coll Cardiol. 2004; 43(6): 1075–1081.
10.1016/j.jacc.2003.10.042
PubMed Web of Science® Google Scholar
18Manganelli P, Bernordi P, Taliani U, et al. Echocardiographic findings in primary Sjogren's syndrome. Ann Rheum Dis. 1997; 56: 568.
10.1136/ard.56.9.568
CAS PubMed Web of Science® Google Scholar
19Lee LA, Pickrell MB, Reichlin M. Development of complete heart block in an adult patient with Sjogren's syndrome and anti-Ro/SS-A autoantibodies. Arthritis Rheum. 1996; 39(8): 1427–1429.
10.1002/art.1780390825
CAS PubMed Web of Science® Google Scholar
20Aktürk E, Yağmur J, Kurtoğlu E, et al. Left atrial volume and function in patients with Behcet's disease assessed by real-time three-dimensional echocardiography. Eur Heart J Cardiovasc Imaging. 2012; 13(8): 650–655.
10.1093/ejechocard/jer301
PubMed Web of Science® Google Scholar
21Ataş H, Kepez A, Tigen K, et al. Evaluation of left atrial volume and function in systemic sclerosis patients using speckle tracking and real-time three-dimensional echocardiography. Anatol J Cardiol. 2016; 16(5): 316–322.
CAS PubMed Web of Science® Google Scholar
22Vassiliou VA, Mayssalus I, Boki KA, et al. Is the heart affected in primary Sjogren's syndrome? An echocardiographic study. Clin Exp Rheumatol. 2008; 26(1): 109–112.
CAS PubMed Web of Science® Google Scholar
23Appenzeller S, Pineau CA, Clarke A. Acute lupus myocarditis: clinical features and outcome. Lupus. 2011; 20(9): 981–988.
10.1177/0961203310395800
CAS PubMed Web of Science® Google Scholar
24Plazak W, Kopec G, Tomkiewicz-Pajak L, et al. Heart structure and function in patients with generalized autoimmune diseases: echocardiography with tissue Doppler study. Acta Cardiol. 2011; 66(2): 159–165.
10.1080/AC.66.2.2071246
PubMed Web of Science® Google Scholar
25Rosato E, Maione S, Vitarelli A, et al. Regional diastolic function by tissue Doppler echocardiography in systemic sclerosis: correlation with clinical variables. Rheumatol Int. 2009; 29(8): 913–919.
10.1007/s00296-008-0827-x
PubMed Web of Science® Google Scholar
26Yagmur J, Cansel M, Kurtoglu E, et al. Assessment of left atrial volume and function by real time three-dimensional echocardiography in obese patients. Echocardiography. 2017; 34: 210–216.
10.1111/echo.13417
PubMed Web of Science® Google Scholar
27Osranek M, Fatema K, Qaddoura F, et al. Left atrial volume predicts the risk of atrial fibrillation after cardiac surgery: a prospective study. J Am Coll Cardiol. 2006; 48(4): 779–786.
10.1016/j.jacc.2006.03.054
PubMed Web of Science® Google Scholar
28Modena MG, Muia N, Sgura FA, et al. Left atrial size is the major predictor of cardiac death and overall clinical outcome in patients with dilated cardiomyopathy: a long-term follow-up study. Clin Cardiol. 1997; 20(6): 553–560.
10.1002/clc.4960200609
CAS PubMed Web of Science® Google Scholar

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Volume37, Issue5

May 2020

Pages 715-721

Assessment of left atrial volume and function in patients with Sjögren's syndrome using three-dimensional echocardiography

Abstract

Objective

Methods

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CONFLICT OF INTEREST

REFERENCES

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References

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Assessment of left atrial volume and function in patients with Sjögren's syndrome using three-dimensional echocardiography

Abstract

Objective

Methods

Results

Conclusion

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

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