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Comment & Response
November 5, 2014

Cardiac Assessment Before Stem Cell Transplantation for Systemic Sclerosis

Author Affiliations
  • 1Division of Immunotherapy, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 2Division of Clinical Immunology, University of São Paulo, Ribeirão Preto, Brazil
  • 3Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
JAMA. 2014;312(17):1803. doi:10.1001/jama.2014.12566

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.

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