title: Myocardial and vascular dysfunction in systemic sclerosis: the potential role of noninvasive assessment in asymptomatic patients.
abstract: Systemic sclerosis (SSc) is a multi-system disorder characterized by widespread vascular lesions and fibrosis of skin and distinct internal organs. The aim of the present study was to analyze possible associations of left ventricular (LV) myocardial function with coronary flow reserve (CFR) and endothelial function in asymptomatic patients with SSc. Thirty healthy subjects and 33 age- and sex-comparable asymptomatic SSc patients underwent standard Doppler Myocardial Imaging, Strain Rate (SR) Imaging of interventricular septum (IVS) and LV lateral wall, transthoracic CFR of left anterior descending coronary vessel, and brachial artery vasodilatation measurement. In SSc patients, LV myocardial early diastolic peak velocity, peak systolic SR and strain were both reduced in basal and middle IVS, and in basal and middle LV lateral wall (p<0.001). In addition, both CFR (p<0.0001) and endothelial flow-mediated dilatation (p<0.001) were significantly lower in SSc patients. By stepwise forward multivariate analyses, CFR (p<0.001) and endothelial function (p<0.001) were powerful independent determinants of middle LV strain of SSc patients. In conclusion, SR Imaging, transthoracic CFR and brachial artery flow-mediated dilatation are valuable non-invasive and easy-repeatable tools for detecting early LV myocardial and vascular involvement caused by SSc.
authors.forename: Antonello
authors.initials: A
authors.lastname: D'Andrea
authors.forename: Pio
authors.initials: P
authors.lastname: Caso
authors.forename: Sergio
authors.initials: S
authors.lastname: Cuomo
authors.forename: Fortunato
authors.initials: F
authors.lastname: Scotto di Uccio
authors.forename: Raffaella
authors.initials: R
authors.lastname: Scarafile
authors.forename: Gemma
authors.initials: G
authors.lastname: Salerno
authors.forename: Silvio
authors.initials: S
authors.lastname: Romano
authors.forename: Stefano
authors.initials: S
authors.lastname: Stisi
authors.forename: Marino
authors.initials: M
authors.lastname: Scherillo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
mesh_terms: D001783:Blood Flow Velocity; D001794:Blood Pressure; D003326:Coronary Circulation; D015150:Echocardiography, Doppler; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012595:Scleroderma, Systemic / Q000150:complications / Q000503:physiopathology*; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*