Cold-induced reversible myocardial ischaemia in systemic sclerosis

Area of Science:

• Cardiology
• Rheumatology
• Medical Imaging

Background:

• Systemic sclerosis can affect various organs, but cardiac involvement is often subclinical.
• Myocardial perfusion abnormalities may precede overt cardiac symptoms in systemic sclerosis.
• Understanding myocardial involvement is crucial for managing systemic sclerosis patients.

Purpose of the Study:

• To investigate the impact of cold provocation on myocardial perfusion in systemic sclerosis.
• To assess the prevalence of perfusion defects in patients with systemic sclerosis compared to healthy controls.
• To explore the relationship between perfusion defects and clinical/electrocardiographic findings.

Main Methods:

• Utilized single photon emission computed tomography (SPECT) with thallium uptake to assess myocardial perfusion.
• Employed a cold provocation test designed to avoid pain and significant hemodynamic changes.
• Compared findings in 21 systemic sclerosis patients and 8 healthy controls.

Main Results:

• Abnormal myocardial perfusion (reversible and/or permanent defects) was detected in 15 out of 21 systemic sclerosis patients.
• No perfusion defects were observed in the 8 healthy controls.
• Perfusion abnormalities were not correlated with patient age, ECG findings, or other systemic sclerosis features.

Conclusions:

• Myocardial perfusion abnormalities are prevalent in systemic sclerosis, often occurring without clinical cardiac evidence.
• Cold-induced vasospasm is a potential contributing factor to myocardial perfusion defects and fibrosis in systemic sclerosis.
• SPECT imaging during cold provocation is valuable for detecting subclinical cardiac involvement in systemic sclerosis.