To the Editor The key to safe hematopoietic stem cell transplantation in patients with systemic sclerosis is a careful pretransplant cardiac assessment and subsequent recognition and management of cardiac complications.1 In the Autologous Stem Cell Transplantation International Scleroderma (ASTIS) trial by Dr van Laar and colleagues,2 the main exclusion criteria for cardiac reasons were left ventricular ejection fraction less than 45% and pulmonary arterial hypertension, defined as a mean pulmonary artery pressure greater than 50 mm Hg by echocardiogram or cardiac catheterization.
Burt RK, Oliveira MC, Shah SJ. Cardiac Assessment Before Stem Cell Transplantation for Systemic Sclerosis. JAMA. 2014;312(17):1803. doi:10.1001/jama.2014.12566