To investigate cardiopulmonary function in progressive systemic sclerosis with diffuse scleroderma, we studied 26 patients with maximal exercise and redistribution thallium scans, rest and exercise radionuclide ventriculography, pulmonary-function testing, and chest roentgenography. Although only 6 patients had clinical evidence of cardiac involvement, 20 had abnormal thallium scans, including 10 with reversible exercise-induced defects and 18 with fixed defects (8 had both). Seven of the 10 patients who had exercise-induced defects and underwent cardiac catheterization had normal coronary angiograms. Mean resting left ventricular ejection fraction and mean resting right ventricular ejection fraction were lower in patients with post-exercise left ventricular thallium defect scores above the median (59 +/- 13 per cent vs. 69 +/- 6 per cent [P less than 0.025], and 36 +/- 12 per cent vs. 47 +/- 7 per cent [P less than 0.025], respectively). We conclude that in progressive systemic sclerosis with diffuse scleroderma, abnormalities of myocardial perfusion are common and appear to be due to a disturbance of the myocardial microcirculation. Both right and left ventricular dysfunction appear to be related to this circulatory disturbance, suggesting ischemically mediated injury.
This article has been cited by other articles:
Vonk Noordegraaf, A., Naeije, R.
(2008). Right ventricular function in scleroderma-related pulmonary hypertension. Rheumatology (Oxford)
47: v42-v43
[Abstract][Full Text]
Roman, M. J., Salmon, J. E.
(2007). Cardiovascular Manifestations of Rheumatologic Diseases. Circulation
116: 2346-2355
[Full Text]
Huez, S., Roufosse, F., Vachiery, J-L., Pavelescu, A., Derumeaux, G., Wautrecht, J-C., Cogan, E., Naeije, R.
(2007). Isolated right ventricular dysfunction in systemic sclerosis: latent pulmonary hypertension?. Eur Respir J
30: 928-936
[Abstract][Full Text]
Taraseviciene-Stewart, L., Nicolls, M. R., Kraskauskas, D., Scerbavicius, R., Burns, N., Cool, C., Wood, K., Parr, J. E., Boackle, S. A., Voelkel, N. F.
(2007). Absence of T Cells Confers Increased Pulmonary Arterial Hypertension and Vascular Remodeling. Am. J. Respir. Crit. Care Med.
175: 1280-1289
[Abstract][Full Text]
Fischer, A., Misumi, S., Curran-Everett, D., Meehan, R. T., Ulrich, S. K., Swigris, J. J., Frankel, S. K., Cosgrove, G. P., Lynch, D. A., Brown, K. K.
(2007). Pericardial Abnormalities Predict the Presence of Echocardiographically Defined Pulmonary Arterial Hypertension in Systemic Sclerosis-Related Interstitial Lung Disease. Chest
131: 988-992
[Abstract][Full Text]
Kahan, A., Allanore, Y.
(2006). Primary myocardial involvement in systemic sclerosis. Rheumatology (Oxford)
45: iv14-iv17
[Abstract][Full Text]
Meune, C., Allanore, Y., Pascal, O., Devaux, J.-Y., Dessault, O., Duboc, D., Weber, S., Kahan, A.
(2005). Myocardial contractility is early affected in systemic sclerosis: A Tissue Doppler echocardiography study. Eur J Echocardiogr
6: 351-357
[Abstract][Full Text]
Vignaux, O, Allanore, Y, Meune, C, Pascal, O, Duboc, D, Weber, S, Legmann, P, Kahan, A
(2005). Evaluation of the effect of nifedipine upon myocardial perfusion and contractility using cardiac magnetic resonance imaging and tissue Doppler echocardiography in systemic sclerosis. Ann Rheum Dis
64: 1268-1273
[Abstract][Full Text]
Lindqvist, P., Caidahl, K., Neuman-Andersen, G., Ozolins, C., Rantapaa-Dahlqvist, S., Waldenstrom, A., Kazzam, E.
(2005). Disturbed Right Ventricular Diastolic Function in Patients With Systemic Sclerosis: A Doppler Tissue Imaging Study. Chest
128: 755-763
[Abstract][Full Text]
Borderie, D., Allanore, Y., Meune, C., Devaux, J. Y., Ekindjian, O. G., Kahan, A.
(2004). High Ischemia-Modified Albumin Concentration Reflects Oxidative Stress But Not Myocardial Involvement in Systemic Sclerosis. Clin. Chem.
50: 2190-2193
[Full Text]
Montisci, R, Vacca, A, Garau, P, Colonna, P, Ruscazio, M, Passiu, G, Iliceto, S, Mathieu, A
(2003). Detection of early impairment of coronary flow reserve in patients with systemic sclerosis. Ann Rheum Dis
62: 890-893
[Abstract][Full Text]
Geirsson, A J, Wollheim, F A, Akesson, A
(2001). Disease severity of 100 patients with systemic sclerosis over a period of 14 years: using a modified Medsger scale. Ann Rheum Dis
60: 1117-1122
[Abstract][Full Text]
Furst, D. E., Clements, P. J., Wong, W. K., Mayes, M. D., Wigley, F., White, B., Weisman, M., Barr, W., Moreland, L., Martin, R., Medsger, T. A. Jr, Steen, V., Collier, D., Weinstein, A., Lally, E., Varga, J., Weiner, S. R., Andrews, B., Abeles, M., Peter, J. B., Seibold, J. R.
(2001). Effects of the American College of Rheumatology systemic sclerosis trial guidelines on the nature of systemic sclerosis patients entering a clinical trial. Rheumatology (Oxford)
40: 615-622
[Abstract][Full Text]
Liangos, O., Neure, L., Kuhl, U., Pauschinger, M., Sieper, J., Distler, A., Schwimmbeck, P. L., Braun, J.
(2000). The possible role of myocardial biopsy in systemic sclerosis. Rheumatology (Oxford)
39: 674-679
[Abstract][Full Text]
Rinaldi, E., Ierardi, M., Tiberio, N.S., Boccabella, G. L., Barbieri, C., Scopinaro, F., Morelli, S., DeSantis, M., Banci, M.
(1998). 99mTc SESTAMIBI Scintigraphic Evaluation of Skeletal Muscle Disease in Patients with Systemic Sclerosis: Diagnostic Reliability and Comparison with Cardiac Function and Perfusion. ANGIOLOGY
49: 641-648
[Abstract]
Ferri, C., Di Bello, V., Martini, A., Giorgi, D., Storino, F. A A, Bianchi, M., Bertini, A., Paterni, M., Giusti, C., Pasero, G.
(1998). Heart involvement in systemic sclerosis: an ultrasonic tissue characterisation study. Ann Rheum Dis
57: 296-302
[Abstract][Full Text]
Previous
