title: Diastolic abnormalities in systemic sclerosis: evidence for associated defective cardiac functional reserve.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Clinical Medicine, Division of Rheumatology, Second University of Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Valentini
authors.forename: D F
authors.initials: DF
authors.lastname: Vitale
authors.forename: A
authors.initials: A
authors.lastname: Giunta
authors.forename: S
authors.initials: S
authors.lastname: Maione
authors.forename: G
authors.initials: G
authors.lastname: Gerundo
authors.forename: M
authors.initials: M
authors.lastname: Arnese
authors.forename: E
authors.initials: E
authors.lastname: Tirri
authors.forename: N
authors.initials: N
authors.lastname: Pelaggi
authors.forename: A
authors.initials: A
authors.lastname: Giacummo
authors.forename: G
authors.initials: G
authors.lastname: Tirri
authors.forename: M
authors.initials: M
authors.lastname: Condorelli
mesh_terms: D000328:Adult; D000368:Aged; D003971:Diastole; D015150:Echocardiography, Doppler; D015444:Exercise / Q000502:physiology; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000150:complications* / Q000503:physiopathology; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology*