COLD-INDUCED CARDIAC ABNORMALITIES IN SYS TEMIC-SCLEROSIS

Cardiac abnormalities are frequent in patients with systemic sclerosis (SS). These abnormalities have been demonstrated in over 80% of patie nts with SS and there are some clues that suggest that an intermittent vascular spasm (i.e. coronary Raynaud's phenomenon) is one of the cau ses of myocardial dysfunction in this group of patients. The aim of th is prospective study was to evaluate the ventricular performance and r egional wall motion during exposure to cold in patients with SS and Ra ynaud' s phenomenon without overt cardiac disease. Twenty-four patient s and 10 normal volunteers underwent radionuclide ventriculograms (RV) . In each subject the RV was done thrice: basal, 20 minutes after chil ling with thermic blanket and post reheating. The left ventricular eje ction fraction (LVEF) decreased during the cold test (p = 0.03) with r eversible abnormalities in wall motion. Basal Right Ventricular Ejecti on Fraction (RVEF) was lower than that of normal subjects (p = 0.02) a nd decreased during the cold test (p = 0.04). Therefore, we were able to demonstrate an early cardiac dysfunction associated with impaired w all motion after corporal chilling. These findings suggest that corona ry spasm in SS would be an early and frequent phenomenon that would pr ecede the development of symptomatic cardiac disease in some patients with this illness.