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Systemic sclerosis and the heart: current diagnosis and management

Chintan S Desai1, Daniel C Lee, Sanjiv J Shah

  • 1Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Current Opinion in Rheumatology
|September 8, 2011
PubMed

Insights

Cardiac involvement in systemic sclerosis (SSc) significantly increases mortality risk. Recent studies define epidemiology and risk factors, highlighting diffuse cutaneous SSc as most susceptible, and explore new diagnostic tools and treatments.

Area of Science:

  • Cardiology
  • Rheumatology
  • Systemic Sclerosis Research

Background:

  • Cardiac involvement in systemic sclerosis (SSc) is a critical determinant of patient survival.
  • Understanding the epidemiology, screening, diagnosis, and treatment of cardiac manifestations in SSc is essential.

Purpose of the Study:

  • To review recent advancements in understanding cardiac involvement in SSc.
  • To highlight key epidemiological findings, diagnostic innovations, and therapeutic strategies.

Main Methods:

  • Review of recent epidemiological studies on cardiac involvement in SSc.
  • Evaluation of diagnostic tools including echocardiography and natriuretic peptides.
  • Analysis of current treatment approaches, particularly calcium channel blockers.

Main Results:

  • Prevalence and risk factors for left ventricular (LV) systolic dysfunction in SSc are better defined, with diffuse cutaneous SSc patients being most vulnerable.
  • Tissue Doppler echocardiography and natriuretic peptides offer insights into subclinical cardiac dysfunction.
  • Emerging techniques like speckle-tracking echocardiography and advanced imaging show promise for further understanding.
  • Observational data supports calcium channel blockers for microvascular ischemia and LV dysfunction prevention, though RCTs are pending.

Conclusions:

  • Recent research has enhanced the understanding of cardiac SSc.
  • Significant questions persist regarding optimal screening, diagnosis, and treatment protocols.
  • Future multicenter studies and novel diagnostic methods are expected to improve patient outcomes.
Abstract

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