Early cardiovascular involvement in patients with systemic sclerosis (SSc).
BACKGROUND
Systemic sclerosis (SSc) is a connective tissue disease characterized by progressive fibrosis of the skin, and by distinctive forms of internal organ involvement. Symptoms usually occur relatively late and are nonspecific, thus often unrecognized. The purpose of our study was to evaluate cardiac function in patients with SSc by means of non-invasive methods in order to detect early dysfunction of the cardiovascular system.


METHODS
A group of 22 patients with SSc was compared with a group of 22 healthy volunteers. Standard EKG, 24-hour Holter monitoring (HM), and echocardiography were performed in all subjects.


RESULTS
In patients with SSc, HM revealed a tendency to tachycardia. Conduction disturbances were observed in 3 patients. In 6 patients significant ventricular arrhythmia was found. Silent ischemia episodes were detected in 6 patients. In HRV analysis, significantly lower values were detected in patients with SSc than in controls. LPs were present in one patient with SSc, and none in the control group. The mean values for QT interval did not exceed the range of normal values. No signs of systolic cardiac dysfunction were detected, while in 6 patients left ventricle diastolic dysfunction was recognized. Valvular lesions were observed in 8 patients, but only in 2 patients were they hemodynamically important.


CONCLUSIONS
24-hour Holter monitoring and echocardiography enable the early detection of cardiovascular dysfunction in patients with systemic sclerosis presenting without apparent cardiac impairment symptoms.
Wranicz
Jerzy
J
Department of Cardiology, Institute of Cardiology, Medical University of Łódź, ul. Sterlinga 1/3, 91-425 Łódź, Poland. holter@csk.am.lodz.pl
Zielińska
Marzenna
M
Cygankiewicz
Iwona
I
Dziankowska-Bartkowiak
Bozena
B
Sysa-Jedrzejowska
Anna
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002319:Cardiovascular System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000503:physiopathology*