Heterogeneous pattern of improvement in right ventricular mechanics following hematopoietic stem cell transplant in patients with systemic sclerosis

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Systemic sclerosis (SSc) is an autoimmune disorder that causes fibrosis in the skin and internal organs, including heart. Patients with SSc can have right ventricular (RV) systolic dysfunction absence pulmonary hypertension. Studies shown a predilection for impairment mid apical segments RV free wall compared to controls. The effect hematopoietic stem cell transplant (HSCT) – disease modifying treatment on mechanics not known. Aim To study HSCT using speckle-tracking echocardiography. Methods who underwent comprehensive 2D echocardiographic evaluation pre- post-HSCT were identified. modified Rodnan score (mRSS) was evaluated each patient post-HSCT. Speckle tracking software utilized measure myocardial strain (TomTec, Unterschleissheim, Germany). measured from focused 4-chamber view. Paired student’s t-test linear regression analysis used data analysis. Results Among 89 patients (average age 46 ± 11 years, 75% female) HSCT, mRSS significantly improved after HSCT. mean arterial pressure by heart catheterization prior 18.5 4.5 mmHg. There significant improvement global longitudinal (GLS) (FWS) following wall, but so basal segment. change linearly related pre-HSCT strain. lower GLS FWS, greater Conclusions undergoing specifically within wall. directly baseline This suggests may improve preferential enhancement less robust segments. Key clinical echo characteristics Pre-HSCT Post-HSCT P value Median (25th - 75th percentile) 20 (13-34) 9 (4-20) <0.01 (%) -18.13 3.88 -20.06 4.51 FWS -20.79 5.30 -23.21 5.61 -27.97 9.33 -27.84 7.94 0.93 -20.68 9.61 -23.75 7.91 0.05 -15.26 8.57 -20.84 8.92 All values are presented as SD unless indicated otherwise. Figure. vs