{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T11:16:03Z","timestamp":1789643763511,"version":"4.0.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Cardiac involvement in systemic sclerosis (scleroderma [SSc]) adversely affects long-term prognosis, often remaining undetectable despite close clinical examination and 2-dimensional echocardiographic monitoring. Speckle-derived strain of the right ventricle (RV) was utilized to detect occult abnormalities in regional and global contractility in SSc patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              A total of 138 SSc patients with technically adequate echocardiograms was studied and compared with 40 age- and sex-matched healthy non-SSc controls. Standard assessment of RV chamber function included tricuspid annular plane systolic excursion and fractional area change. RV longitudinal systolic speckle-derived strain was assessed in the basal, mid, and apical free wall. Tricuspid annular plane systolic excursion was not different between groups (\n              <jats:italic>P<\/jats:italic>\n              =0.307). Although fractional area change was lower in SSc patients than in controls (mean, 48.9 versus 55;\n              <jats:italic>P<\/jats:italic>\n              =0.002), the mean fractional area change was still within the normal range (&gt;35). In contrast, RV longitudinal systolic speckle-derived strain measures were significantly different between groups, both globally (\u221220.4% versus \u221217.7%;\n              <jats:italic>P<\/jats:italic>\n              =0.005) and regionally: they were decreased in the apex (\u22128.5% versus \u221217.1%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) and mid segments (\u221212.4% versus -20.9%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), and increased in the base (\u221232.2% versus \u221223.3%;\n              <jats:italic>P<\/jats:italic>\n              =0.0001) for the SSc group. The regional difference in the base compared with the apex was significantly greater for SSc than for controls (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001 for interaction). The differences observed in regional strain between SSc and control were unchanged after adjusting for RV systolic pressure.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Speckle-derived strain reveals a heterogenous pattern of regional heart strain in SSc that is not detected by conventional measures of function, suggestive of occult RV myocardial disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.115.003792","type":"journal-article","created":{"date-parts":[[2016,6,8]],"date-time":"2016-06-08T02:04:26Z","timestamp":1465351466000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":95,"title":["Unique Abnormalities in Right Ventricular Longitudinal Strain in Systemic Sclerosis Patients"],"prefix":"10.1161","volume":"9","author":[{"given":"Monica","family":"Mukherjee","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (M.M., V.K.T., R.J.T., T.P.A.), Division of Pulmonary and Critical Care Medicine (S.-E.C.), and Division of Rheumatology (L.K.H., F.M.W., A.A.S.), Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shang-En","family":"Chung","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (M.M., V.K.T., R.J.T., T.P.A.), Division of Pulmonary and Critical Care Medicine (S.-E.C.), and Division of Rheumatology (L.K.H., F.M.W., A.A.S.), Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Von Khue","family":"Ton","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (M.M., V.K.T., R.J.T., T.P.A.), Division of Pulmonary and Critical Care Medicine (S.-E.C.), and Division of Rheumatology (L.K.H., F.M.W., A.A.S.), Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J.","family":"Tedford","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (M.M., V.K.T., R.J.T., T.P.A.), Division of Pulmonary and Critical Care Medicine (S.-E.C.), and Division of Rheumatology (L.K.H., F.M.W., A.A.S.), Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura K.","family":"Hummers","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (M.M., V.K.T., R.J.T., T.P.A.), Division of Pulmonary and Critical Care Medicine (S.-E.C.), and Division of Rheumatology (L.K.H., F.M.W., A.A.S.), Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrick M.","family":"Wigley","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (M.M., V.K.T., R.J.T., T.P.A.), Division of Pulmonary and Critical Care Medicine (S.-E.C.), and Division of Rheumatology (L.K.H., F.M.W., A.A.S.), Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore P.","family":"Abraham","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (M.M., V.K.T., R.J.T., T.P.A.), Division of Pulmonary and Critical 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