[The heart in scleroderma. Phonoechocardiographic study]

We performed phono-ecocardiograms in 11 normotensive patients with scleroderma, all of them below age 50. We compared the parameters measured with a control group of normal subjects. In 18% of the patients studied we found S-3, in 55% S-4. The following abnormalities were significant in the soleroderma group: prolongation of the prejection period (p less than 0.05) decrease of mean velocity of introventricular pressure (p less than 0.01) and also decrease of the contractility index. On the other hand the "A" index of the apexcardiogram was increased (p less than 0.005). In the echocardiogram we found diminished septal and posterior wall thickness (p less than 0.05 and 0.01 respectively). Perirardial effusion was evident in 2 patients. One had mitral disease that resembled rheumatic heart disease. One had calcification of the mitral ring. Two patients had signs of pulmonary hypertensión. We concluded that scleroderma heart disease shows initially decrease compliance, later on it affects systolic function and only in the advanced stages can be manifested as either congestive or restrictive myocardiopathy.