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Updated: Feb 12, 2026
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Exercise Hemodynamics for the Diagnosis of Diastolic Dysfunction in Dyspneic Patients with Systemic Sclerosis
Anne Graham Cummiskey1,2, Amit Segev1,3, Michael Segel4,3
1Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.
Objectives:
To assess the added diagnostic value of using exercise hemodynamics during RHC in assessment of patients with symptomatic SSc.
Methods:
We performed 22 RHCs in 17 SSc patients with dyspnea and/or pulmonary arterial hypertension (PAH). Exercise was performed in 15 RHCs using isotonic arm exercises while holding a 1 kg weight in each hand. Measurements of pulmonary arterial pressure (PAP), pulmonary arterial wedge pressure (PAWP), and cardiac output (CO) were taken at rest and during peak exercise.
Results:
Normal resting RHC (PAP 22 3 mmHg, PAWP 11 3 mmHg) was found in seven cases. Of these, exercise induced elevation in PAP was found in three (38 7 mmHg), and exercise induced elevation in PAWP was found in four (24 6 mmHg). Elevated resting PAP was found in 15 (41 11 mmHg) with minor changes in exercise. Of the 22 RHCs, elevation of the PAWP was found in 11 (50%), half of which were in response to exercise.
Conclusions:
In symptomatic SSc patients, exercise hemodynamics provides important information on diastolic dysfunction that is not available with non-invasive testing. Findings on exercise RHC can explain patient symptoms in up to 50% of cases. Earlier and more accurate diagnosis of patient symptoms can aid in tailoring the correct therapy for each.
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