Comprehensive noninvasive assessment of cardiac involvement in limited systemic sclerosis

Arthritis Rheum. 1996 Jul;39(7):1138-45. doi: 10.1002/art.1780390710.


Objective: To assess cardiovascular abnormalities in patients with limited systemic sclerosis (SSc), using noninvasive cardiac techniques.

Methods: Sixty-three patients with limited SSc were prospectively evaluated with Doppler echocardiography and thallium-201 perfusion scintigraphy after a cold-stress test and radionuclide ventriculography.

Results: In the patients with limited SSc, there was a significantly high prevalence of abnormal left- and right-diastolic function parameters (P = 0.001 and P = 0.0002, respectively), thickening of papillary muscles (46%; P = 0.003), and mild mitral regurgitation (49%; P < 0.0001), compared with controls. Systolic pulmonary arterial hypertension was detected in 9 patients (14%), and pericardial effusion in 11 patients (18%). In 64% of patients with limited SSc, an ischemic response was detected on the thallium cold-stress scan; similarly, an ischemic response was detected in 57% of patients with primary Raynaud's phenomenon (P < 0.0001 versus controls).

Conclusion: Although the frequency of cardiovascular symptoms was low in patients with limited SSc, a significant rate of cardiovascular abnormalities was found by noninvasive cardiac techniques.

MeSH terms

  • Adult
  • Echocardiography, Doppler
  • Female
  • Heart Diseases / diagnostic imaging
  • Heart Diseases / epidemiology
  • Heart Diseases / etiology*
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / epidemiology
  • Mitral Valve Stenosis / complications
  • Mitral Valve Stenosis / epidemiology
  • Myocardial Ischemia / complications
  • Myocardial Ischemia / diagnostic imaging
  • Myocardial Ischemia / epidemiology
  • Pericardial Effusion / complications
  • Pericardial Effusion / epidemiology
  • Prevalence
  • Prospective Studies
  • Radionuclide Imaging
  • Scleroderma, Systemic / complications*
  • Ventricular Function