COMPREHENSIVE NONINVASIVE ASSESSMENT OF CARDIAC INVOLVEMENT IN LIMITED SYSTEMIC-SCLEROSIS

Objective. To assess cardiovascular abnormalities in patients with lim ited systemic sclerosis (SSc), using noninvasive cardiac techniques. M ethods. Sixty-three patients with limited SSc were prospectively evalu ated with Doppler echocardiography and thallium-201 perfusion scintigr aphy after a cold-stress test and radionuclide ventriculography. Resul ts. In the patients with limited SSc, there was a significantly high p revalence of abnormal left- and right-diastolic function parameters (P = 0.001 and P = 0.0002, respectively), thickening of papillary muscle s (46%; P = 0.003), and mild mitral regurgitation (49%; P < 0.0001), c ompared with controls, Systolic pulmonary arterial hypertension was de tected in 9 patients (14%), and pericardial effusion in 11 patients (1 8%). In 64% of patients with limited SSc, an ischemic response was det ected on the thallium cold-stress scan; similarly, an ischemic respons e was detected in 57% of patients with primary Raynaud's phenomenon (P < 0.0001 versus control). Conclusion. Although the frequency of cardi ovascular symptoms was low in patients with limited SSc, a significant rate of cardiovascular abnormalities was found by noninvasive cardiac techniques.