Non‐invasive assessment of left ventricular diastolic function in patients with systemic sclerosis

Abstract. To evaluate the extent of left ventricular (LV) diastolic impairment in systemic sclerosis, we examined 30 consecutive patients (15 men and 15 women) with this condition, and compared the findings with the data for 48 age‐ and sex‐matched randomly sampled controls. All patients were investigated by phonocardiography, pulse curve recording, and M‐mode echocardiography. Twenty‐three of 30 (77%) patients had LV hypertrophy and/or diastolic impairment. Interventricular septum (P= 0.0001), LV posterior wall (P< 0.05), and the wall thickness to cavity dimension ratio (P< 0.001) were increased in patients compared to controls, as was LV mass index (P< 0.002). Five patients had asymmetric septal hypertrophy. LV end‐diastolic dimension did not differ between groups. LV distensibility was impaired, as judged from apexcardiographic a/H ratio (P< 0.05) and from an increased left atrial index (P< 0.005). LV early filling was impaired, with a reduced left atrial emptying index (P= 0.0001), and a reduced rate of dimension increase in digitized M‐mode (P< 0.02). We found no evidence of impaired LV relaxation. Blood pressure did not differ between patients and controls. With longer duration of the disease, left atrial dimension appeared to increase (r = 0.42, P< 0.05), while other variables were not related to disease duration. The impaired LV filling was not secondary to systolic dysfunction. We conclude that systemic sclerosis patients have an increased LV wall thickness, with impaired early filling properties and LV distensibility. 1990 Blackwell Publishing Ltd