title: [Cold-induced cardiac abnormalities in systemic sclerosis].
abstract: Cardiac abnormalities are frequent in patients with systemic sclerosis (SS). These abnormalities have been demonstrated in over 80% of patients with SS and there are some clues that suggest that an intermittent vascular spasm (i.e. coronary Raynaud's phenomenon) is one of the causes of myocardial dysfunction in this group of patients. The aim of this prospective study was to evaluate the ventricular performance and regional wall motion during exposure to cold in patients with SS and Raynaud's phenomenon without overt cardiac disease. Twenty-four patients and 10 normal volunteers underwent radionuclide ventriculograms (RV). In each subject the RV was done thrice: basal, 20 minutes after chilling with thermic blanket and post reheating. The left ventricular ejection fraction (LVEF) decreased during the cold test (p = 0.03) with reversible abnormalities in wall motion. Basal Right Ventricular Ejection Fraction (RVEF) was lower than that of normal subjects (p = 0.02) and decreased during the cold test (p = 0.04). Therefore, we were able to demonstrate an early cardiac dysfunction associated with impaired wall motion after corporal chilling. These findings suggest that coronary spasm in SS would be an early and frequent phenomenon that would precede the development of symptomatic cardiac disease in some patients with this illness.
authors.affiliation: Facultad de Medicina, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
authors.forename: R H
authors.initials: RH
authors.lastname: Rey
authors.forename: G
authors.initials: G
authors.lastname: Marrero
authors.forename: A
authors.initials: A
authors.lastname: Chwojnik
authors.forename: J
authors.initials: J
authors.lastname: Martínez Martínez
authors.forename: J
authors.initials: J
authors.lastname: Maldonado Cocco
authors.forename: S
authors.initials: S
authors.lastname: Rodrigué
authors.forename: H
authors.initials: H
authors.lastname: Casabé
mesh_terms: D000328:Adult; D003329:Coronary Vasospasm / Q000150:complications*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015635:Radionuclide Ventriculography; D012594:Scleroderma, Localized / Q000503:physiopathology*; D012595:Scleroderma, Systemic / Q000503:physiopathology*; D013318:Stroke Volume; D016276:Ventricular Function / Q000502:physiology
vernacular_title: Alteraciones cardíacas inducidas por el frío en la esclerosis sistémica.