Left and right heart diseases, including pulmonary arterial hypertension (PAH), left ventricular hypertrophy, and diastolic dysfunction, are frequently found in patients with systemic sclerosis, according to a prospective study conducted in France.

In the study, outlined in the January issue of the Annals of the Rheumatic Diseases, a total of 570 consecutive patients with systemic sclerosis without severe pulmonary function abnormalities, severe cardiac disease or known PAH underwent Doppler echocardiography.

PAH was suspected in 33 patients and was confirmed in 18 by right heart catheterization.

LV systolic dysfunction was rare, found in just 1.4 per cent of patients, Dr. Pascal de Groote of Hopital Cardiologique, Lille and colleagues report. However, LV hypertrophy was more common, seen in 22.6 per cent of patients, with LV diastolic dysfunction present in 17.7 per cent of the cohort.

Moreover, the investigators identified a small group of 21 patients (8 per cent) with a restrictive mitral flow pattern in the absence of any other cardiopulmonary diseases. "It is possible that these patients represent a subgroup of patients with a specific cardiac involvement in systemic sclerosis," they write.

Summing up, Dr. de Groote and colleagues note that there has been "increasing awareness" of LV diastolic abnormalities in patients with systemic sclerosis. The researchers are assessing the prognostic implications of the LV abnormalities in the three-year follow up of this cohort.