Cardiac involvement in limited systemic sclerosis: Non-invasive assessmentin asymptomatic patients

Nineteen patients with limited systemic sclerosis (SSc) and without any car diac symptoms were evaluated mn-invasively for silent cardiac involvement u sing electrocardiography; M-mode, two-dimensional and Doppler echocardiogra phy, and resting and post exercise radionuclide ventriculography. Left ante rior hemiblock and mild pericardial effusion were seen in two patients. The interventricular septal thickness and left ventricular posterior wall thic kness were greater in patients compared with controls. Patients with limite d SSc also exhibited low early diastolic filling velocities and a low early diastolic atrial filling ratio. However, these values did not correlate wi th the age of the patient or disease duration. Eight patients (42.1%) were found to have cardiac dysfunction, of which four had combined systolic and diastolic dysfunction. Isolated systolic and diastolic dysfunction was seen in three patients and one patient, respectively. The age and disease durat ion in patients with cardiac dysfunction did not differ from patients witho ut cardiac dysfunction. Functional cardiac involvement occurs in a large pr oportion (42.1%) of patients with limited SSc, and can be easily picked up by non-invasive methods such as echocardiography and radionuclide ventricul ography. The prognostic significance of these findings requires further lon g term studies.