Objectives To investigate cardiac valve morphology and left ventricular ejection fraction (LVEF) in patients with systemic sclerosis (SSc) and matched population controls. We also studied the occurrence and relationship between manifest cardiovascular disease (CVD) and abnormal echocardiography findings.
Methods 110 patients (62±12 years) with SSc were compared with 105 age and gender matched population-based controls (61±12 years). CVD was defined as a history of objectively verified angina pectoris, myocardial infarction, cerebral infarction or intermittent claudication. Echocardiography was performed to assess valvular abnormalities and left ventricular function.
Results 44 SSc patients had an abnormal echocardiogram compared to 23subjects in the control population (P<0.001). On group basis SSc patients had lower (but normal) LVEF (P=0.02). Three of the SSc patients had undergone valve replacement and one had a significant aortic insufficiency. Two subjects in the control group had undergone valve replacement. Valve thickening or valve prosthesis was found in 28 patients and 19 controls (NS). 20 SSc patients and 7 control subjects had previous CVD (p<0.01). Seven patients had previous myocardial infarction (MI), 8 had angina (among them two with MI), 7 patients had peripheral vascular disease, among them 5 had undergone surgery (2 of them also had an MI). Among patients with CVD 8 had valve thickening or prosthesis, 5 had LV hypokinesia, 3 had LVEF ≤35, six had PAH (defined as TI velocity>2.9m/s). Among controls with CVD 3 had MI, 4 had CVL. Three controls vith CVD had valve thickening, all had normal LVEF and none had PAH.
Conclusions SSc patients have a higher prevalence of abnormal echocardiograms than population based controls. Previous CVD is more common among the SSC patients. Valve thickening or valve prosthesis was not more common among the SSc patients than population controls. On group basis SSc patients had lower (but normal) LVEF though more SSc patients than controls had regional hypokinesia (P=0.02).
Disclosure of Interest None Declared
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