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Ann Rheum Dis. Jul 1996; 55(7): 455–460.
PMCID: PMC1010209

Diastolic abnormalities in systemic sclerosis: evidence for associated defective cardiac functional reserve.


OBJECTIVE: To investigate the pattern of diastolic abnormalities in patients with systemic sclerosis (SSc) and the relationship between impaired ventricular filling and systolic function. METHODS: Twenty four patients with SSc underwent M-mode and two dimensional echocardiography using echo-Doppler and gated blood pool cardiac angiography, both at rest and after exercise. RESULTS: An impaired diastolic relaxation of the left ventricle was detected in 10 of the 24 patients with SSc. Left ventricular ejection fraction at rest in these 10 patients with impaired ventricular filling did not differ from that in the remaining 14 patients, but eight of the 10 failed to increase their ejection fraction during exercise, compared with two of the 14 with normal ventricular filling (p = 0.003). CONCLUSION: Impaired relaxation of the left ventricle is a recently described feature of scleroderma heart disease. Diastolic dysfunction in SSc could depend on myocardial fibrosis or myocardial ischaemia, or both. It was found to be associated with a defective cardiac functional reserve. However, its prognostic significance remains to be clarified.

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Selected References

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  • D'Angelo WA, Fries JF, Masi AT, Shulman LE. Pathologic observations in systemic sclerosis (scleroderma). A study of fifty-eight autopsy cases and fifty-eight matched controls. Am J Med. 1969 Mar;46(3):428–440. [PubMed]
  • Bulkley BH, Ridolfi RL, Salyer WR, Hutchins GM. Myocardial lesions of progressive systemic sclerosis. A cause of cardiac dysfunction. Circulation. 1976 Mar;53(3):483–490. [PubMed]
  • Follansbee WP, Miller TR, Curtiss EI, Orie JE, Bernstein RL, Kiernan JM, Medsger TA., Jr A controlled clinicopathologic study of myocardial fibrosis in systemic sclerosis (scleroderma). J Rheumatol. 1990 May;17(5):656–662. [PubMed]
  • Follansbee WP, Curtiss EI, Medsger TA, Jr, Steen VD, Uretsky BF, Owens GR, Rodnan GP. Physiologic abnormalities of cardiac function in progressive systemic sclerosis with diffuse scleroderma. N Engl J Med. 1984 Jan 19;310(3):142–148. [PubMed]
  • Kahan A, Devaux JY, Amor B, Menkès CJ, Weber S, Nitenberg A, Venot A, Guérin F, Degeorges M, Roucayrol JC. Nifedipine and thallium-201 myocardial perfusion in progressive systemic sclerosis. N Engl J Med. 1986 May 29;314(22):1397–1402. [PubMed]
  • Alexander EL, Firestein GS, Weiss JL, Heuser RR, Leitl G, Wagner HN, Jr, Brinker JA, Ciuffo AA, Becker LC. Reversible cold-induced abnormalities in myocardial perfusion and function in systemic sclerosis. Ann Intern Med. 1986 Nov;105(5):661–668. [PubMed]
  • Ellis WW, Baer AN, Robertson RM, Pincus T, Kronenberg MW. Left ventricular dysfunction induced by cold exposure in patients with systemic sclerosis. Am J Med. 1986 Mar;80(3):385–392. [PubMed]
  • Labovitz AJ, Pearson AC. Evaluation of left ventricular diastolic function: clinical relevance and recent Doppler echocardiographic insights. Am Heart J. 1987 Oct;114(4 Pt 1):836–851. [PubMed]
  • Brutsaert DL, Sys SU, Gillebert TC. Diastolic failure: pathophysiology and therapeutic implications. J Am Coll Cardiol. 1993 Jul;22(1):318–325. [PubMed]
  • Maione S, Valentini G, Giunta A, Migliaresi S, Itri F, Picillo U, Tirri G, Condorelli M. Evaluation of cardiac structures and function in systemic sclerosis by Doppler echocardiography. Cardiology. 1991;79(3):165–171. [PubMed]
  • Kazzam E, Waldenström A, Landelius J, Hällgren R, Arvidsson A, Caidahl K. Non-invasive assessment of left ventricular diastolic function in patients with systemic sclerosis. J Intern Med. 1990 Aug;228(2):183–192. [PubMed]
  • Pace L, Capelli L, Bove E, Coppola N, Ciarmiello A, Sorrentino S, Salvatore M. Left ventricular diastolic function in systemic sclerosis: assessment by radionuclide angiography. J Nucl Med. 1992 Jan;33(1):68–72. [PubMed]
  • Giordano M, Valentini G, Migliaresi S, Picillo U, Vatti M. Different antibody patterns and different prognoses in patients with scleroderma with various extent of skin sclerosis. J Rheumatol. 1986 Oct;13(5):911–916. [PubMed]
  • Steen VD, Medsger TA, Jr, Rodnan GP. D-Penicillamine therapy in progressive systemic sclerosis (scleroderma): a retrospective analysis. Ann Intern Med. 1982 Nov;97(5):652–659. [PubMed]
  • Casas JA, Subauste CP, Alarcón GS. A new promising treatment in systemic sclerosis: 5-fluorouracil. Ann Rheum Dis. 1987 Oct;46(10):763–767. [PMC free article] [PubMed]
  • Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978 Dec;58(6):1072–1083. [PubMed]
  • Bonow RO, Bacharach SL, Green MV, Kent KM, Rosing DR, Lipson LC, Leon MB, Epstein SE. Impaired left ventricular diastolic filling in patients with coronary artery disease: assessment with radionuclide angiography. Circulation. 1981 Aug;64(2):315–323. [PubMed]
  • Polak JF, Kemper AJ, Bianco JA, Parisi AF, Tow DE. Resting early peak diastolic filling rate: a sensitive index of myocardial dysfunction in patients with coronary artery disease. J Nucl Med. 1982 Jun;23(6):471–478. [PubMed]
  • Channer KS, Culling W, Wilde P, Jones JV. Estimation of left ventricular end-diastolic pressure by pulsed Doppler ultrasound. Lancet. 1986 May 3;1(8488):1005–1007. [PubMed]
  • Brutsaert DL, Rademakers FE, Sys SU. Triple control of relaxation: implications in cardiac disease. Circulation. 1984 Jan;69(1):190–196. [PubMed]
  • Gaasch WH, Blaustein AS, Bing OH. Asynchronous (segmental early) relaxation of the left ventricle. J Am Coll Cardiol. 1985 Apr;5(4):891–897. [PubMed]
  • Blaustein AS, Gaasch WH. Myocardial relaxation. VI. Effects of beta-adrenergic tone and asynchrony on LV relaxation rate. Am J Physiol. 1983 Mar;244(3):H417–H422. [PubMed]
  • Lew WY, Rasmussen CM. Influence of nonuniformity on rate of left ventricular pressure fall in the dog. Am J Physiol. 1989 Jan;256(1 Pt 2):H222–H232. [PubMed]
  • Takeuchi M, Fujitani K, Kurogane K, Bai HT, Toda C, Yamasaki T, Fukuzaki H. Effects of left ventricular asynchrony on time constant and extrapolated pressure of left ventricular pressure decay in coronary artery disease. J Am Coll Cardiol. 1985 Sep;6(3):597–602. [PubMed]
  • Siegel RJ, O'Connor B, Mena I, Criley JM. Left ventricular function at rest and during Raynaud's phenomenon in patients with scleroderma. Am Heart J. 1984 Dec;108(6):1469–1476. [PubMed]

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