Rheumatology Advance Access published online on January 20, 2004
Rheumatology, doi:10.1093/rheumatology/keh087
Rheumatology © British Society for Rheumatology 2004; all rights reserved
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Original Papers
1 Division of Rheumatology, Department of Internal Medicine, University of Genova, Genova, Italy
* Corresponding author. E-mail: albertosulli{at}unige.it.
Received 19 August 2003
; revised 31 October 2003
Objectives. We investigated whether the non-invasive determination of coronary flow reserve (CFR), as evaluated by transthoracic Doppler echocardiography, might be a potential method to detect early dysfunction of cardiovascular system in patients affected by systemic sclerosis (SSc) without clinical signs or symptoms of cardiac impairment. The possible correlations between the CFR values and the duration of the disease, specific autoantibodies and cutaneous involvement subsets were investigated. Methods. Forty-four consecutive patients affected by SSc were analysed. The CFR was detected in the distal left anterior descending coronary artery by contrast-enhanced transthoracic second harmonic Doppler in all SSc patients and in 16 healthy controls. CFR was assessed at rest and during hyperaemia induced by administration of adenosine at 0.14 mg/kg/min over 5 min. The CFR was calculated as the ratio between hyperaemic (peak adenosine infusion) and resting peak diastolic velocity (PdvCFR) and resting velocity time integral (VtiCFR). Past medical history was carefully investigated. Results. Both PdvCFR and VtiCFR were significantly reduced in SSc patients when compared with controls (P<0.0001). In particular, both PdvCFR and VtiCFR were significantly lower in patients with dSSc when compared with patients affected by lSSc (P<0.02 and P<0.04 respectively). No statistically significant correlation was found between CFR values and history of smoking, serum levels of cholesterol or triglycerides, blood pressure, age of patients, duration of SSc and serum autoantibody positivity for ANA, ACA and Scl70. Conclusions. CFR is often reduced in SSc patients. CFR was lower in patients with dSSc than in those affected by lSSc. A reduced CFR value should be considered an indirect sign of heart involvement in scleroderma, but its clinical and prognostic implications need to be clarified.
Key words: Systemic sclerosis, Coronary flow reserve, Heart disease, Doppler echocardiography.
Blunted coronary flow reserve in systemic sclerosis
2 Division of Immunology and Internal Medicine, Department of Internal Medicine, University of Genova, Genova, Italy
3 Division of Cardiology, Department of Internal Medicine, University of Genova, Genova, Italy
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  L. Belloli, N. Carlo-Stella, G. Ciocia, A. Chiti, M. Massarotti, and B. Marasini Myocardial involvement in systemic sclerosis Rheumatology, July 1, 2008; 47(7): 1070 - 1072. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Szucs, O. Timar, Z. Szekanecz, H. Der, G. Kerekes, S. Szamosi, Y. Shoenfeld, G. Szegedi, and P. Soltesz Endothelial dysfunction precedes atherosclerosis in systemic sclerosis--relevance for prevention of vascular complications Rheumatology, May 1, 2007; 46(5): 759 - 762. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Kahan and Y. Allanore Primary myocardial involvement in systemic sclerosis Rheumatology, October 1, 2006; 45(suppl_4): iv14 - iv17. [Abstract] [Full Text] [PDF]
|
|