TY - JOUR
T1 - Left ventricular dysfunction induced by cold exposure in patients with systemic sclerosis
AU - Ellis, William W.
AU - Baer, Alan N.
AU - Robertson, Rose Marie
AU - Pincus, Theodore
AU - Kronenberg, Marvin W.
N1 - Funding Information:
From the Division of Cardiology and the Division of Rheumatology and immunology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee. This work was supported in part by a National Research Service Award (5T32HL0741) from the National Heart, Lung and Blood Institute, Bethesda, Maryland, by a Grant-in-Aid from the American Heart Association, with funds in part from the Tennessee Affiliate, and by Multipurpose Arthritis Center Grant AM 22071, the Jack C. Massey Foundation, and the Maury County Lupus Fund. Dr. Baer is an Associate Investigator of the Veterans Administration. Dr. Robertson is an Established Investigator of the American Heart Association. Dr. Kronenberg is the recipient of a Research Career Development Award (5K04HL00852) from the National Heart, Lung and Blood Institute. This report was presented in part at the Southeastern Regional Meeting of the American Rheumatism Association, Lake Buena Vista, Florida, December 9, 1983. Requests for reprints should be addressed to Dr. Marvin W. Kronenberg, Division of Cardiology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232. Manuscript accepted July 10, 1985.
PY - 1986/3
Y1 - 1986/3
N2 - Raynaud's phenomenon and cardiac abnormalities are frequent in patients with systemic sclerosis. Radionuclide ventriculograms were obtained in 16 patients with Raynaud's phenomenon and systemic sclerosis or the related CREST syndrome and in 11 normal volunteers in order to evaluate changes in left ventricular function that might be induced by exposure to cold. Left ventricular regional wall motion abnormalities developed in nine of 16 patients during cooling compared with only one of 11 control subjects, despite a comparable rise in mean arterial pressure (p <0.02). The abnormalities occurred in seven of 11 patients with systemic sclerosis, one of four with CREST syndrome, and one with Raynaud's disease. To test the potential protective effect of nifedipine, radionuclide ventriculograms were then obtained during cooling after sublingual nifedipine (20 mg). Only five of 13 patients had wall motion abnormalities, and the severity of the abnormalities was significantly less than during the first cooling period (p = 0.03). Five of eight patients who had cold-induced wall motion abnormalities during the first cooling period had none after nifedipine, whereas two other patients demonstrated small abnormalities only during the second cooling period after treatment with nifedipine. It is concluded that cold induces segmental myocardial dysfunction in patients with systemic sclerosis and that nifedipine may blunt the severity of this abnormal response.
AB - Raynaud's phenomenon and cardiac abnormalities are frequent in patients with systemic sclerosis. Radionuclide ventriculograms were obtained in 16 patients with Raynaud's phenomenon and systemic sclerosis or the related CREST syndrome and in 11 normal volunteers in order to evaluate changes in left ventricular function that might be induced by exposure to cold. Left ventricular regional wall motion abnormalities developed in nine of 16 patients during cooling compared with only one of 11 control subjects, despite a comparable rise in mean arterial pressure (p <0.02). The abnormalities occurred in seven of 11 patients with systemic sclerosis, one of four with CREST syndrome, and one with Raynaud's disease. To test the potential protective effect of nifedipine, radionuclide ventriculograms were then obtained during cooling after sublingual nifedipine (20 mg). Only five of 13 patients had wall motion abnormalities, and the severity of the abnormalities was significantly less than during the first cooling period (p = 0.03). Five of eight patients who had cold-induced wall motion abnormalities during the first cooling period had none after nifedipine, whereas two other patients demonstrated small abnormalities only during the second cooling period after treatment with nifedipine. It is concluded that cold induces segmental myocardial dysfunction in patients with systemic sclerosis and that nifedipine may blunt the severity of this abnormal response.
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U2 - 10.1016/0002-9343(86)90711-4
DO - 10.1016/0002-9343(86)90711-4
M3 - Article
C2 - 3953616
AN - SCOPUS:0022573835
SN - 0002-9343
VL - 80
SP - 385
EP - 392
JO - The American journal of medicine
JF - The American journal of medicine
IS - 3
ER -