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[Sclerodermic cardiomyopathy : prospective study employing phonocardiography and echocardiography. Value of diastolic parameters of ventricular function (author's transl)].

A prospective study in 30 patients with systemic sclerosis included phonocardiographic (PCG) recordings in all cases and an echocardiogram (ECHO) in 18 patients. A specific diagnosis of myocardial fibrosis was established in 2 cases, based on anatomical criteria, and was suspected in 5 patients from combined clinical, electrical, and radiological findings. Ventricular diameters, the slope of mitral valve closure, and systolic parameters of ventricular function (haemodynamic quotient, left ventricle ejection fraction, and mean rate of circumferential shortening) were rarely abnormal, and did not correlate with possible myocardial fibrosis. Diastolic pick-up (PCG) was abnormal in 30 p. cent of the cases but this is not specific to myocardial fibrosis. Total myocardial relaxation interval, as measured by PCG, was significantly increased to 146 +/- 23 ms (mean +/- one standard deviation) in relation to a control group (p less than 0.001). A relaxation interval (measured by PCG and/or ECHO) superior to 150 ms is suggestive of myocardial fibrosis. The rate of thinning of the left ventricular posterior wall was diminished in the 14 cases in which it was measured. These results are in favour of a myocardial relaxation disorder during scleroderma.