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At enrollment, no patient showed signs and\/or symptoms suggestive for cardiac involvement. No patient showed traditional cardiovascular risk factors. Both the 12\u2010lead electrocardiogram examination and echocardiographic evaluation did not show any alterations in our cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Stress perfusion defects of left ventricle were detected in six out of 16 (37.5%) patients and these defects did not match with the coronary flow distribution. The results showed the presence of two different patterns of stress perfusion defects: sub\u2010endocardial and\/or a midmyocardial. The presence of stress perfusion defects did not correlate with any clinical feature of enrolled patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Myocardial stress perfusion defects may be detected early by pharmacological stress perfusion <jats:styled-content style=\"fixed-case\">CMR<\/jats:styled-content>, a reliable and sensitive technique for the noninvasive evaluation of <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c heart disease, in patients with <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c of recent onset. These defects seem to be independent from traditional risk factors and associated comorbidities, suggesting they are a specific hallmark of the disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.13107","type":"journal-article","created":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T01:16:42Z","timestamp":1496625402000},"page":"1247-1260","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Pharmacological stress, rest perfusion and delayed enhancement cardiac magnetic resonance identifies very early cardiac involvement in systemic sclerosis patients of recent onset"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0670-9638","authenticated-orcid":false,"given":"Roberto","family":"Giacomelli","sequence":"first","affiliation":[{"name":"Division of Rheumatology Department of Biotechnological and Applied Clinical Science School of Medicine University of L'Aquila L'Aquila 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