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Primary Heart Involvement in Systemic Sclerosis

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Systemic sclerosis (SSc) is a connective tissue disease characterised by widespread vascular lesions and fibrosis of the skin and internal organs. Cardiac involvement is recognised as a poor prognostic factor when clinically evident. Primary myocardial involvement is common in SSc. Increasing evidence strongly suggests that myocardial involvement is related to repeated focal ischaemia leading to myocardial fibrosis with irreversible lesions. This results from microcirculation impairment with abnormal vasoreactivity, with or without associated structural vascular abnormalities.

Myocardial perfusion impairment, abnormal systolic and diastolic left ventricular dysfunction and right ventricular dysfunction have been reported in SSc, using conventional methods. Recent methods such as tissue Doppler echocardiography and magnetic resonance imaging have underlined these results. These sensitive and quantitative methods have demonstrated the ability of vasodilators, including calcium channel blockers and angiotensin converting enzyme inhibitors, to improve both perfusion and function abnormalities.

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Keywords: Systemic sclerosis; calcium channel blockers; myocardium; vasospasm

Document Type: Research Article

Affiliations: Service de Rhumatologie A,Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France

Publication date: 01 August 2006

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  • Current Rheumatology Reviews publishes frontier reviews on all the latest advances on rheumatology and its related areas e.g. pharmacology, pathogenesis, epidemiology, clinical care, and therapy. The journal's aim is to publish the highest quality review articles dedicated to clinical research in the field.

    The journal is essential reading for all researchers and clinicians in rheumatology.
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