{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T04:20:59Z","timestamp":1771042859592,"version":"3.50.1"},"reference-count":51,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2024,10,20]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This study aimed to evaluate cardiac function using Myocardial Performance Index (MPI) in autoimmune connective tissue disease (ACTD) patients without cardiovascular abnormalities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A systematic search of databases including Medline, Google Scholar, ProQuest, Scopus and Cochrane Library was conducted to identify relevant studies on ACTD and MPI from 1995 to 2023. ACTD included in the search were rheumatoid arthritis (RA), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), Sj\u00f6gren syndrome (SjD), polymyositis and dermatomyositis. Quality assessment was performed using the Newcastle-Ottawa Scale, followed by meta-analysis computation of mean differences (MDs) of MPI using Review Manager V.5.4.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 22 studies for qualitative and 19 for quantitative synthesis were included. We found six studies on RA, eight studies on SSc, five studies on SLE, two studies on SjD and one on mixed connective tissue disorder. Conventional echocardiography and tissue Doppler imaging (TDI) were used to assess the MPI. Both conventional MPI and tissue Doppler MPI values were elevated compared with healthy control (MD=0.11, 95%\u2009CI 0.08 to 0.14, p value&lt;0.00001\u2009and MD=0.06, 95% CI 0.03 to 0.10, p value=0.00001, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We found elevated MPI values in patients with ACTD compared with healthy controls. MPI assessment has the potential for early detection and management of cardiac dysfunction in patients with ACTD, but further studies are required to corroborate these findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>CRD42023490643.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/lupus-2024-001272","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T01:25:27Z","timestamp":1732152327000},"page":"e001272","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Myocardial Performance Index to assess cardiac function in autoimmune connective tissue disease: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4895-2409","authenticated-orcid":false,"given":"Rudy","family":"Hidayat","sequence":"first","affiliation":[{"name":"Rheumatology Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia"},{"name":"Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0173-049X","authenticated-orcid":false,"given":"Sally Aman","family":"Nasution","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0762-0408","authenticated-orcid":false,"given":"Faisal","family":"Parlindungan","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia"},{"name":"Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6391-5828","authenticated-orcid":false,"given":"Naomi Niari","family":"Dalimunthe","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Sumatra Utara, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1783-8531","authenticated-orcid":false,"given":"Steven","family":"Alvianto","sequence":"additional","affiliation":[{"name":"Jakarta Rheumatic and Autoimmune Diseases Study Group (Jak-RAIDS), Jakarta, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4093-0782","authenticated-orcid":false,"given":"Nicolas Daniel","family":"Widjanarko","sequence":"additional","affiliation":[{"name":"Jakarta Rheumatic and Autoimmune Diseases Study Group (Jak-RAIDS), Jakarta, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2047-9373","authenticated-orcid":false,"given":"Ummi","family":"Kultsum","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital-Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9587-5444","authenticated-orcid":false,"given":"Cristopher","family":"Efendi","sequence":"additional","affiliation":[{"name":"Jakarta Rheumatic and Autoimmune Diseases Study Group (Jak-RAIDS), Jakarta, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3746-5402","authenticated-orcid":false,"given":"Yovita","family":"Gotama","sequence":"additional","affiliation":[{"name":"Jakarta Rheumatic and Autoimmune Diseases Study Group (Jak-RAIDS), Jakarta, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"2025091515073278000_11.2.e001272.1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00829-2015"},{"key":"2025091515073278000_11.2.e001272.2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.684699"},{"key":"2025091515073278000_11.2.e001272.3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-221733"},{"key":"2025091515073278000_11.2.e001272.4","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.122.027846","article-title":"Sore, Hot, and at Risk: the Emerging Specialty of Cardio-Rheumatology","volume":"12","author":"Weber","year":"2023","journal-title":"J Am Heart Assoc"},{"key":"2025091515073278000_11.2.e001272.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0121976","article-title":"Cardiovascular Involvement in Connective Tissue Disease: the Role of Interstitial Lung Disease","volume":"10","author":"Wang","year":"2015","journal-title":"PLoS ONE"},{"key":"2025091515073278000_11.2.e001272.6","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s12016-010-8251-x","article-title":"Cardiovascular risk in rheumatoid arthritis and systemic autoimmune rheumatic disorders: a suggested model of preventive strategy","volume":"44","author":"Bartoloni","year":"2013","journal-title":"Clin Rev Allergy Immunol"},{"key":"2025091515073278000_11.2.e001272.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(05)80111-7"},{"key":"2025091515073278000_11.2.e001272.8","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1530\/ERP-20-0017","article-title":"The prognostic value of Tei index in acute myocardial infarction: a systematic review","volume":"7","author":"Bennett","year":"2020","journal-title":"Echo Res Pract"},{"key":"2025091515073278000_11.2.e001272.9","first-page":"222","article-title":"The role of Tei index added to the GRACE risk score for prediction of in-hospital MACE after acute myocardial infarction","volume":"60","author":"Dalimunthe","year":"2022","journal-title":"Rom J Intern Med"},{"key":"2025091515073278000_11.2.e001272.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.026"},{"key":"2025091515073278000_11.2.e001272.11","first-page":"4399","article-title":"Can myocardial dysfunction be detected in patients with rheumatoid arthritis with no cardiac symptoms?","volume":"27","author":"Akg\u00f6l","year":"2023","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2025091515073278000_11.2.e001272.12","doi-asserted-by":"crossref","first-page":"2663","DOI":"10.1007\/s10067-015-3163-z","article-title":"Arterial stiffness is associated with left ventricular dysfunction in patients with rheumatoid arthritis","volume":"35","author":"Ilter","year":"2016","journal-title":"Clin Rheumatol"},{"key":"2025091515073278000_11.2.e001272.13","first-page":"41","article-title":"Color and tissue doppler echocardiographical findings in patients with rheumatoid arthritis","volume":"10","author":"Caglayan","year":"2018","journal-title":"Int Arch Med Res"},{"key":"2025091515073278000_11.2.e001272.14","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-002-0677-y"},{"key":"2025091515073278000_11.2.e001272.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1368-5031.2006.00746.x"},{"key":"2025091515073278000_11.2.e001272.16","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-003-0342-z"},{"key":"2025091515073278000_11.2.e001272.17","first-page":"269","article-title":"Assessment of left and right ventricular diastolic function in patients with systemic sclerosis","volume":"66","author":"Ciurzy\u0144ski","year":"2008","journal-title":"Kardiol Pol"},{"key":"2025091515073278000_11.2.e001272.18","doi-asserted-by":"crossref","first-page":"445","DOI":"10.5114\/aoms.2014.43739","article-title":"Heart diastolic dysfunction in patients with systemic sclerosis","volume":"10","author":"Ciurzy\u0144ski","year":"2014","journal-title":"Arch Med Sci"},{"key":"2025091515073278000_11.2.e001272.19","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.090931"},{"key":"2025091515073278000_11.2.e001272.20","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.ihj.2015.06.021","article-title":"Right ventricular thickness as predictor of global myocardial performance in systemic sclerosis: a Doppler tissue imaging study","volume":"67","author":"Karna","year":"2015","journal-title":"Ind Heart J"},{"key":"2025091515073278000_11.2.e001272.21","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1111\/echo.12774","article-title":"Evaluation of global function of the heart in scleroderma patients","volume":"32","author":"Gerede","year":"2015","journal-title":"Echocardiography"},{"key":"2025091515073278000_11.2.e001272.22","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/j.1540-8175.2011.01560.x","article-title":"Which factors impact myocardial function in systemic sclerosis?","volume":"29","author":"Ivanovic","year":"2012","journal-title":"Echocardiography"},{"key":"2025091515073278000_11.2.e001272.23","doi-asserted-by":"crossref","first-page":"94","DOI":"10.5472\/marumj.472397","article-title":"The effect of cold stress on right ventricular function in patients with systemic sclerosis","volume":"31","author":"Yilmaztepe","year":"2018","journal-title":"Marmara Med J"},{"key":"2025091515073278000_11.2.e001272.24","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1177\/147323000503300407","article-title":"Tissue Doppler echocardiography and myocardial performance index in patients with scleroderma","volume":"33","author":"G\u00fcll\u00fcl\u00fc","year":"2005","journal-title":"J Int Med Res"},{"key":"2025091515073278000_11.2.e001272.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2005.10.018"},{"key":"2025091515073278000_11.2.e001272.26","first-page":"1019","article-title":"Evaluation of early cardiac dysfunction in patients with systemic lupus erythematosus with or without anticardiolipin antibodies","volume":"24","author":"Barutcu","year":"2015","journal-title":"Lupus (Los Angel)"},{"key":"2025091515073278000_11.2.e001272.27","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.ejr.2013.07.002","article-title":"Evaluation of left ventricular myocardial function in Egyptian patients with systemic lupus erythematosus: tissue Doppler study and its relation to disease activity","volume":"35","author":"Allam","year":"2013","journal-title":"Egypt Rheumatol"},{"key":"2025091515073278000_11.2.e001272.28","doi-asserted-by":"crossref","first-page":"S33","DOI":"10.1016\/j.ejr.2015.05.002","article-title":"Assessment of left ventricular function in systemic lupus erythematosus patients by speckle tracking echocardiography: Relation to circulating endothelial progenitor cells","volume":"37","author":"Bakhoum","year":"2015","journal-title":"Egypt Rheumatol"},{"key":"2025091515073278000_11.2.e001272.29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2005.04015.x"},{"key":"2025091515073278000_11.2.e001272.30","doi-asserted-by":"crossref","DOI":"10.25011\/cim.v35i5.18703","article-title":"Atrial electromechanical delay and diastolic dysfunction in primary Sj\u00f6gren syndrome","volume":"35","author":"Akyel","year":"2012","journal-title":"Clin Invest Med"},{"key":"2025091515073278000_11.2.e001272.31","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1111\/1756-185X.12049","article-title":"Assessment of left ventricular functions in patients with Sj\u00f6gren\u2019s syndrome using tissue Doppler echocardiography","volume":"16","author":"Bayram","year":"2013","journal-title":"Int J Rheum Dis"},{"key":"2025091515073278000_11.2.e001272.32","first-page":"132","article-title":"Echocardiographic Prevalence and Risk Predictors of Ventricular Dysfunction in Connective Tissue Disorders: tertiary Care Hospital-Based Prospective Case-Control Study","volume":"1","author":"Thakur","year":"2020","journal-title":"Ind J Clin Cardiol"},{"key":"2025091515073278000_11.2.e001272.33","doi-asserted-by":"crossref","first-page":"2437","DOI":"10.1007\/s10067-016-3373-z","article-title":"Heart involvement in systemic lupus erythematosus: a systemic review and meta-analysis","volume":"35","author":"Chen","year":"2016","journal-title":"Clin Rheumatol"},{"key":"2025091515073278000_11.2.e001272.34","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1111\/echo.15628","article-title":"Myocardial performance index and cardiovascular diseases","volume":"40","author":"Askin","year":"2023","journal-title":"Echocardiography"},{"key":"2025091515073278000_11.2.e001272.35","doi-asserted-by":"crossref","first-page":"3908","DOI":"10.18203\/2320-6012.ijrms20184881","article-title":"Evaluation of correlation between myocardial performance index and left ventricular ejection fraction in patients with acute ST-elevation myocardial infarction","volume":"6","author":"Benjamin","year":"2018","journal-title":"Int J Res Med Sci"},{"key":"2025091515073278000_11.2.e001272.36","first-page":"75","article-title":"Non-invasive prediction of ST elevation myocardial infarction complications by left ventricular Tei index","volume":"59","author":"Rahman","year":"2009","journal-title":"J Pak Med Assoc"},{"key":"2025091515073278000_11.2.e001272.37","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.ehj.2017.12.001","article-title":"Myocardial performance index as an echocardiographic predictor of early in-hospital heart failure during first acute anterior ST-elevation myocardial infarction","volume":"70","author":"Abuomara","year":"2018","journal-title":"Egypt Heart J"},{"key":"2025091515073278000_11.2.e001272.38","doi-asserted-by":"crossref","first-page":"622","DOI":"10.4103\/2249-4863.214431","article-title":"Prevalence of left ventricular dysfunction in rheumatoid arthritis","volume":"6","author":"Renjith","year":"2017","journal-title":"J Family Med Prim Care"},{"key":"2025091515073278000_11.2.e001272.39","first-page":"28","article-title":"Speckle tracking can detect subclinical myocardial dysfunction in rheumatoid arthritis patients","volume":"118","author":"Benacka","year":"2017","journal-title":"Bratisl Lek Listy"},{"key":"2025091515073278000_11.2.e001272.40","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1002\/art.42054","article-title":"Diastolic Dysfunction in Systemic Sclerosis: Risk Factors and Impact on Mortality","volume":"74","author":"Hinze","year":"2022","journal-title":"Arthritis Rheumatol"},{"key":"2025091515073278000_11.2.e001272.41","first-page":"1986","article-title":"The clinical implications of left ventricular diastolic dysfunction in systemic sclerosis","volume":"40","author":"Ross","year":"2022","journal-title":"Clin Exp Rheumatol"},{"key":"2025091515073278000_11.2.e001272.42","first-page":"327","article-title":"Cardiac manifestations in Sjogren syndrome","volume":"36","author":"Ye","year":"2008","journal-title":"Zhonghua Xin Xue Guan Bing Za Zhi"},{"key":"2025091515073278000_11.2.e001272.43","doi-asserted-by":"crossref","DOI":"10.1136\/ard.56.9.568","article-title":"Echocardiographic findings in primary Sj\u00f6gren\u2019s syndrome","volume":"56","author":"Manganelli","year":"1997","journal-title":"Ann Rheum Dis"},{"key":"2025091515073278000_11.2.e001272.44","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390825"},{"key":"2025091515073278000_11.2.e001272.45","first-page":"59","article-title":"A Cross-sectional Study of Cardiovascular Involvement in Systemic Lupus Erythematosus in an Urban Indian Tertiary Care Centre with Emphasis on 2-D Echocardiography","volume":"65","author":"Kini","year":"2017","journal-title":"J Assoc Physicians India"},{"key":"2025091515073278000_11.2.e001272.46","doi-asserted-by":"crossref","unstructured":"Ho CY , Solomon SD . A Clinician\u2019s Guide to Tissue Doppler Imaging. Circulation 2006;113. doi:10.1161\/CIRCULATIONAHA.105.579268","DOI":"10.1161\/CIRCULATIONAHA.105.579268"},{"key":"2025091515073278000_11.2.e001272.47","doi-asserted-by":"publisher","DOI":"10.1016\/j.euje.2005.01.007"},{"key":"2025091515073278000_11.2.e001272.48","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8175.2003.03086.x"},{"key":"2025091515073278000_11.2.e001272.49","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209223"},{"key":"2025091515073278000_11.2.e001272.50","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s10238-019-00600-8","article-title":"Early echocardiographic detection of left ventricular diastolic dysfunction in patients with systemic lupus erythematosus asymptomatic for cardiovascular disease","volume":"20","author":"Leone","year":"2020","journal-title":"Clin Exp Med"},{"key":"2025091515073278000_11.2.e001272.51","article-title":"How does age at onset influence the outcome of autoimmune diseases?","volume":"2012","author":"Amador-Patarroyo","year":"2012","journal-title":"Autoimmune Dis"}],"container-title":["Lupus Science &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/lupus-2024-001272","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T22:07:44Z","timestamp":1757974064000},"score":1,"resource":{"primary":{"URL":"https:\/\/lupus.bmj.com\/lookup\/doi\/10.1136\/lupus-2024-001272"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":51,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,11,20]]},"published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1136\/lupus-2024-001272"],"URL":"https:\/\/doi.org\/10.1136\/lupus-2024-001272","relation":{},"ISSN":["2053-8790"],"issn-type":[{"value":"2053-8790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11]]}}}