Decreased coronary reserve in primary scleroderma myocardial disease

• Published in: Arthritis and rheumatism Vol. 28; no. 6; p. 637
• Main Authors: Kahan, A, Nitenberg, A, Foult, J M, Amor, B, Menkes, C J, Devaux, J Y, Blanchet, F, Perennec, J, Lutfalla, G, Roucayrol, J C
• Format: Journal Article
• Language: English
• Published: United States 01.06.1985
• Subjects: Adult; Cardiomyopathies - etiology; Cardiomyopathies - pathology; Cardiomyopathies - physiopathology; Coronary Circulation; Coronary Vessels - pathology; Dipyridamole; Female; Hemodynamics; Humans; Middle Aged; Myocardium - metabolism; Myocardium - pathology; Oxygen Consumption; Scleroderma, Systemic - complications; Scleroderma, Systemic - pathology; Scleroderma, Systemic - physiopathology; Vascular Resistance
• ISSN: 0004-3591
• DOI: 10.1002/art.1780280607

We assessed coronary reserve, by measuring the increase in coronary sinus blood flow (CSBF) after intravenous administration of dipyridamole (0.14 mg/kg/minute for 4 minutes), in 7 patients with primary scleroderma myocardial disease (PSMD) and in 7 control subjects. Coronary reserve was greatly impaired in PSMD: before administration of dipyridamole, CSBF was similar in patients with PSMD (89 +/- 32 ml/minute/100 gm, mean +/- SD) and in controls (100 +/- 15 ml/minute/100 gm); after dipyridamole infusion, CSBF was significantly lower in patients with PSMD (191 +/- 45 ml/minute/100 gm) than in controls (399 +/- 58 ml/minute/100 gm) (P less than 0.01). Six of the 7 patients with PSMD had angiographically normal epicardial coronary arteries and normal left ventricular function. Decreased coronary reserve may be an important contributor to the pathogenesis of primary scleroderma myocardial disease.