Left ventricular longitudinal strain in patients with undifferentiated connective tissue disease and arrhythmia

Aim . To evaluate the left ventricular longitudinal strain in patients with arrhythmia and undifferentiated connective tissue disease (UCTD). Material and methods . This cross-sectional comparative study included young patients with arrhythmia and UCTD (43 men and 84 women; mean age, 30,82±8,17 years (group 1, n=127)). The control group included volunteers with single phenotypic characteristics of UCTD, comparable in age and sex (9 men and 21 women, mean age, 34,13±6,87 years (group 2, n=30)). A standard clinical examination, 72-hour electrocardiographic monitoring, and speckle-tracking echocardiography were performed. Results . Patients of group 1 were characterized by lower global systolic longitudinal myocardial strain compared to the control group: -22,96% [-24,56%; -21,50%] in group 1 vs -24,73% [-25,25%; -23,84%] in group 2 (p=0,016). A local decrease in longitudinal myocardial strain (in two or more segments) was noted in 62,2% of patients in group 1 and 13,3% of patients in group 2 (p=0,025). In group 1, a relationship was revealed between class I premature ventricular contractions (PVCs) and a longitudinal strain decrease in the medial anterior (r 1 =0,253, p=0,004) and apical anterior (r 1 =0,253, p=0,004) segments, as well as between class V PVCs and strain decrease in the basal lower (r 1 =0,215, p=0,021) and middle anterior (r 1 =0,211, p=0,023) segments. In addition, there was a moderate correlation between mitral valve prolapse (MVP) and a decrease in longitudinal systolic strain in the basal inferolateral (r 1 =0,405, p=0,041) and basal anterior (r 1 =0,519, p=0,003) segments. Conclusion . Local decrease in left ventricular longitudinal systolic strain in association with arrhythmia and MVP in patients with UCTD makes it possible to recommend speckle-tracking echocardiography for early non-invasive assessment of myocardial remodeling in this cohort of patients.