Effect of systemic sclerosis on left ventricular long-axis motion and leftventricular mass assessed by magnetic resonance

The aim of this study was to assess the effect of scleroderma on left ventr icular mass and subendocardial function using cardiovascular magnetic reson ance (CMR) to determine parameters reflecting early dysfunction from fibros is. Fifteen patients,vith a history of scleroderma had left ventricular mas s measured with standard techniques and regional subendocardial contractile function assessed using myocardial velocity mapping in the basal short-axi s plane with long-axis sensitized velocity mapping. Peak myocardial velocit ies in systole and diastole were measured to reflect systolic and diastolic function. The variance in the regional myocardial velocity was determined as a parameter of function heterogeneity around the ventricle. The results were compared with 19 healthy volunteers without a history of cardiovascula r disease. In 10 patients, pulmonary transfer-factor was measured using a s ingle-breath helium dilution technique. The duration of scleroderma correla ted with left ventricular mass (r = 0.7, p < 0.05), the coefficient of vari ation of velocity (r = 0.63, p < 0.05), and inversely with the mean left ve ntricular diastolic long-axis velocity (r = -0.63, p < 0.05). There was als o a correlation between left ventricular diastolic long-axis velocity and t he pulmonary transfer factor (r = 0.7, p < 0.05). Trends suggested differen ces between control subjects and scleroderma patients for mean systolic (64 vs. 49 mm/sec, p = 0.09) and diastolic (90 vs. 72 mm/sec, p = 0.07) veloci ties, as well as velocity variance (26 vs. 33, p = 0.09). in conclusion, th ere is a relationship between duration of scleroderma and both left ventric ular mass and diastolic function, which may result from increased myocardia l fibrosis. Trends suggest absolute differences in functional values with c ontrol subjects that reflect impaired diastolic and systolic function, with greater regional heterogeneity that is consistent with nonuniform collagen deposition, bur a larger sample size is required to confirm this. CMR shou ld be explored further as a technique for monitoring myocardial involvement in scleroderma noninvasively.