title: Physiologic abnormalities of cardiac function in progressive systemic sclerosis with diffuse scleroderma.
abstract: To investigate cardiopulmonary function in progressive systemic sclerosis with diffuse scleroderma, we studied 26 patients with maximal exercise and redistribution thallium scans, rest and exercise radionuclide ventriculography, pulmonary-function testing, and chest roentgenography. Although only 6 patients had clinical evidence of cardiac involvement, 20 had abnormal thallium scans, including 10 with reversible exercise-induced defects and 18 with fixed defects (8 had both). Seven of the 10 patients who had exercise-induced defects and underwent cardiac catheterization had normal coronary angiograms. Mean resting left ventricular ejection fraction and mean resting right ventricular ejection fraction were lower in patients with post-exercise left ventricular thallium defect scores above the median (59 +/- 13 per cent vs. 69 +/- 6 per cent [P less than 0.025], and 36 +/- 12 per cent vs. 47 +/- 7 per cent [P less than 0.025], respectively). We conclude that in progressive systemic sclerosis with diffuse scleroderma, abnormalities of myocardial perfusion are common and appear to be due to a disturbance of the myocardial microcirculation. Both right and left ventricular dysfunction appear to be related to this circulatory disturbance, suggesting ischemically mediated injury.
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D009202:Cardiomyopathies / Q000209:etiology; D017023:Coronary Angiography; D003326:Coronary Circulation; D005080:Exercise Test; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008833:Microcirculation; D008875:Middle Aged; D011868:Radioisotopes; D011877:Radionuclide Imaging; D012595:Scleroderma, Systemic / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013318:Stroke Volume; D013793:Thallium
chemical_list: D011868:Radioisotopes; D013793:Thallium