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High prevalence of right ventricular systolic dysfunction in early systemic sclerosis
Christophe Meune1, Yannick Allanore, Jean-Yves Devaux
1Department of Cardiology, Cochin Hospital, APHP, Paris V University, Paris, France.
The Journal of Rheumatology
|October 7, 2004
Summary
Early systemic sclerosis (SSc) patients often show reduced right ventricular ejection fraction (RVEF), potentially due to heart muscle issues. Nicardipine, a calcium channel blocker, acutely improved RVEF in these patients.
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Systemic sclerosis (SSc) is an autoimmune disease affecting connective tissues.
- Early SSc can impact cardiac function, particularly the right ventricle (RV).
- Assessing RV function is crucial for managing SSc patients.
Purpose of the Study:
- To evaluate right ventricular (RV) function in patients with early systemic sclerosis (SSc).
- To determine the acute effects of calcium channel blockers on right ventricular ejection fraction (RVEF).
Main Methods:
- Prospective evaluation of 42 early SSc patients (disease duration < 5 years) with normal pulmonary arterial pressure.
- Utilized pulmonary function testing, echocardiography, and radionuclide ventriculography.
- Assessed RV function at rest and 2 hours post-nicardipine administration, compared to 20 controls.
Main Results:
- SSc patients exhibited significantly lower baseline left ventricular ejection fraction (LVEF) and RVEF compared to controls.
- Reduced RVEF (<35%) was observed in 16 patients; 10 had reduced peak filling rate (PFR).
- Nicardipine significantly increased RVEF (36.5% to 42.3%), with no significant change in mean arterial pressure.
Conclusions:
- Reduced RVEF is a common finding in early systemic sclerosis.
- Intrinsic myocardial involvement is a likely cause of impaired RV function in SSc.
- Nicardipine demonstrates an acute beneficial effect on RVEF in these patients.