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International Journal of Rheumatology
Volume 2010 (2010), Article ID 496509, 9 pages
Review Article

Identification of Myocardial Damage in Systemic Sclerosis: A Nuclear Cardiology Approach

1Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa 920-8641, Japan
2Department of Dermatology, Kanazawa University Hospital, Kanazawa 920-8641, Japan

Received 25 April 2010; Revised 12 July 2010; Accepted 27 July 2010

Academic Editor: Lorinda Chung

Copyright © 2010 Kenichi Nakajima et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Myocardial involvement is an important prognostic factor in patients with systemic sclerosis, and early diagnosis and staging of the disease have been sought after. Since myocardial damage is characterized by connective tissue disease, including fibrosis and diffuse vascular lesions or microcirculation, nuclear myocardial perfusion imaging has been a promising option for evaluating myocardial damages in early stages. In addition to the conventional stress-rest perfusion imaging, the current use of quantitative electrocardiographic gated imaging has contributed to more precise evaluation of cardiac perfusion, ventricular wall motion, and diastolic function, all of which have enhanced diagnostic ability of evaluating myocardial dysfunction. Abnormal sympathetic imaging with Iodine-123 metaiodobenzylguanidine might be another option for identifying myocardial damage. This paper deals with approaches from nuclear cardiology to detect perfusion and functional abnormality as an early sign of myocardial involvement as well as possible prognostic values in patients with abnormal imaging results. The role of nuclear cardiology in the era of multiple imaging modalities is discussed.