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Scanning Electron Microscopy of Macerated Tissue to Visualize the Extracellular Matrix
Published on: June 14, 2016
Characterization of the Left Ventricular Myocardium in Systemic Sclerosis
Briella K Egberts1,2,3, Rajiv Ananthakrishna1,2,3,4,5, Ranjit Shah1,2,3
1College of Medicine and Public Health, Flinders University, Bedford Park 5042, Australia.
Journal of Clinical Medicine
|August 28, 2025
Summary
Systemic sclerosis patients without heart disease show subclinical left ventricular ischemia and impaired oxygenation response to stress. This suggests early coronary microvascular dysfunction and fibrosis contribute to cardiovascular risk.
Area of Science:
- Cardiology
- Radiology
- Rheumatology
Background:
- Cardiac involvement is common in systemic sclerosis (SSc), but left ventricular (LV) ischemia mechanisms are unclear.
- Pulmonary artery hypertension (PAH) is recognized, yet LV ischemia requires further investigation.
- Oxygen-sensitive cardiovascular magnetic resonance (OS-CMR) offers novel insights into myocardial oxygenation and ischemia.
Purpose of the Study:
- To evaluate myocardial deoxygenation changes using LV OS-CMR in SSc patients without known cardiac disease.
- To assess subclinical cardiac involvement in SSc using advanced CMR techniques.
- To investigate early coronary microvascular dysfunction and LV myocardial fibrosis in SSc.
Main Methods:
- Prospective recruitment of SSc patients and age/sex-matched healthy volunteers (HVs).
- Comprehensive cardiovascular magnetic resonance (CMR) including native T1 mapping, rest/stress OS-CMR, stress perfusion, and late gadolinium enhancement (LGE).
- Transthoracic echocardiography (TTE) to assess cardiac function.
Main Results:
- SSc patients exhibited significantly lower global LV OS-CMR signal intensity compared to HVs (p=0.011).
- 87% of SSc patients showed impaired myocardial oxygenation response (OS-CMR SI change ≤10%) in at least one segment.
- Reduced LV global longitudinal strain (GLS) (p=0.045) and evidence of diffuse fibrosis (abnormal T1 mapping in 78%) were observed in SSc patients.
Conclusions:
- SSc patients without known cardiovascular disease or PAH demonstrate subclinical LV ischemia and impaired stress-induced myocardial oxygenation.
- LV myocardial deformation abnormalities and diffuse fibrosis are present in SSc patients compared to controls.
- Findings suggest early coronary microvascular dysfunction and LV fibrosis contribute to cardiovascular risk in SSc, independent of PAH.
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