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Objective: The aim of this study was to determine the frequency and the causes of left ventricular systolic dysfunction (LVSD) in systemic sclerosis (SSc) patients. Methods: SSc patients admitted to the Rheumatology Department of Faculty of Medicine, Hacettepe University between January 2015 and February 2017 were included in the study. The echocardiographic results of the patients were evaluated retrospectively and a left ventricular ejection fraction (LVEF) of <50% was defined as LVSD. Demographic and clinical characteristics of patients with and without LVSD were compared. Results: Two hundred and sixty-two (female/male: 240/22) SSc patients were included. Diffuse SSc was present in 65 (24.8%) patients. Eight (3.1%) patients had LVSD. No significant difference was found between patients with and without LVSD in terms of gender, disease duration, disease type, autoantibody specifity and the frequency of interstitial lung disease and/or pulmonary arterial hypertension; however, patients with LVSD were older (p=0.02) and had coronary artery disease (CAD) more frequently (p<0.001). In three patients, the cause of LVSD was coronary artery disease, and the age at diagnosis of LVSD in these patients was higher than patients without CAD (p=0.03). Results of cardiac magnetic resonance imaging were available in 4 of SSc patients with LVSD and revealed myocardial involvement of SSc in 2 patients. Conclusion: In this study, the frequency of LVSD in SSc patients was consistent with the literature. Microvascular ischemia and CAD may play a role in the etiology of LVSD in patients with SSc and especially elderly patients should be evaluated carefully for the presence of CAD. [ABSTRACT FROM AUTHOR]

Objective: Endothelial dysfunction and vasculopathy are crucial pathogenic factors in systemic sclerosis. Increased concentrations of plasma asymmetric dimethylarginine (ADMA) may also contribute to endothelial dysfunction in patients with systemic sclerosis. We evaluated the relationship between ADMA and aortic elastic properties in patients with systemic sclerosis. Material and Method: Plasma ADMA levels were measured in 30 patients with systemic sclerosis (28 females, mean age 40.7±11.6) and 30 healthy subjects (27 females, mean age 40.6±13). Aortic stiffness was determined with echocardiography. Results: In patients with systemic sclerosis, the mean value of ADMA was 0.53±0.13µmol/l compared with 0.46±0.15 µmol/l for control group. Systolic blood pressure, pulse pressure and aortic 'strain were found to be higher in patients with systemic sclerosis (p=0.027, p=0.048, p=0.037, respectively), diyastolic blood pressure and aortic distensibility was found lower in systemic sclerosis (p=0.039, p=0.045, respectively). There was no significant correlations between ADMA and aortic 'strain'. Conclusion: ADMA serum levels were increased in patients with systemic sclerosis, but no significant correlation was found between ADMA and aort's elastic structure (aortic 'strain', distensibility, and aortic stiffness index). [ABSTRACT FROM AUTHOR]