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Blunted coronary flow reserve in systemic sclerosis: a sign of cardiac involvement in asymptomatic patients
  1. A Sulli1,
  2. M Ghio3,
  3. G P Bezante2,
  4. L Deferrari2,
  5. C Craviotto1,
  6. V Sebastiani2,
  7. M Setti3,
  8. G Filaci3,
  9. F Puppo3,
  10. A Barsotti2,
  11. M Cutolo1,
  12. F Indiveri3
  1. 1Division of Rheumatology, Department of Internal Medicine, University of Genova, Genova, Italy
  2. 2Division of Cardiology, Department of Internal Medicine, University of Genova, Genova, Italy
  3. 3Division of Immunology and Internal Medicine, Department of Internal Medicine, University of Genova, Genova, Italy
  1. Correspondence to:
    Dr A Sulli
    Research Laboratory and Division of Rheumatology, Department of Internal Medicine, University of Genova, Viale Benedetto XV No 6, 16132 Genova, Italy; albertosulliunige.it

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Cardiac disease is often present in systemic sclerosis (SSc), even if rarely of clinical significance.1–3 Therefore, we investigated the coronary flow reserve (CFR), by transthoracic contrast enhanced second harmonic Doppler echocardiography, a non-invasive method that might detect early heart dysfunction in patients with SSc even in the absence of clinical signs or symptoms.

Twenty nine consecutive patients (2 male, 27 female, mean (SD) age 55 (14) years) affected by SSc,4,5 not complaining of signs or symptoms of cardiovascular involvement, were recruited. No further serious disease other than SSc was present. Eleven healthy subjects matched for age and sex (mean (SD) age 53 (5) years) were also evaluated as controls. Echocardiography was performed with an ultrasound unit using a broadband transducer with second harmonic …

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