Non-invasive diagnostic and functional evaluation of cardiac and pulmonary involvement in systemic sclerosis

Gianluigi Sergiacomi, Domenico De Nardo, Ambrogio Capria, Guglielmo Manenti, Sebastiano Fabiano, Mauro Borzi, Giuliana De Sanctis, Daniel Konda, Massimiliano Sperandio, Orazio Schillaci, Salvatore Masala, Giovanni Simonetti, Luigi Fontana

Research output: Contribution to journalArticle

Abstract

Background: The aim of the present study was to evaluate the role of non-invasive methods in the early detection of pulmonary and cardiac involvement in Systemic sclerosis (SSc) and to identify clinical and/or instrumental patterns of prognostic value. Patients and Methods: Twenty female patients affected by SSc (8 with diffuse cutaneous SSc and 12 with limited cutaneous SSc) were enrolled in our study. Cardiac and pulmonary involvement (respiratory function tests and carbon monoxide lung diffusion [DLCO ], chest radiography, high resolution computed tomography [HRCT] and lung perfusion magnetic resonance) were evaluated. Results: All 18 patients studied with respiratory function tests showed a significant reduction of DLCO. HRCT was considerably more sensitive than traditional chest radiography (59% versus 28%; p <0.05). Lung perfusion MRI revealed normal findings in 15 patients. Abnormal lung perfusion MRI results were found only in 3 patients. Angina pectoris with electrocardiographic and scintigraphic ischemic changes, severe regional wall motion abnormalities and complex arrhythmias seemed to be associated with poor prognosis. Conclusion: Taken together these results indicate that a pulmonary involvement occurs both in limited and in diffuse cutaneous SSc patients and develops, in 83% of the cases, without any regional lung perfusion abnormality. Furthermore, cardiac involvement is detected in 65% of the cases as a consequence of a range of noxious events including myocardial ischemia, fibrosis and pressure overload which may result in ventricular dysfunction and arrhythmias. Lung perfusion MRI should be considered as a complementary diagnostic method for the functional evaluation of these symptoms in systemic sclerosis.

Original languageEnglish
Pages (from-to)229-236
Number of pages8
JournalIn Vivo
Volume18
Issue number2
Publication statusPublished - Mar 2004

    Fingerprint

Keywords

  • Lung perfusion MRI
  • Perfusion 2-D dynamic breath-hold technique
  • Systemic Sclerosis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Sergiacomi, G., De Nardo, D., Capria, A., Manenti, G., Fabiano, S., Borzi, M., De Sanctis, G., Konda, D., Sperandio, M., Schillaci, O., Masala, S., Simonetti, G., & Fontana, L. (2004). Non-invasive diagnostic and functional evaluation of cardiac and pulmonary involvement in systemic sclerosis. In Vivo, 18(2), 229-236.