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Consensus best practice pathway of the UK Systemic Sclerosis Study group: management of cardiac disease in systemic
Lesley-Anne Bissell1,2, Marina Anderson3, Malcolm Burgess4
1Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds.
Insights
Cardiac disease in systemic sclerosis (SSc) requires expert management. This pathway guides early detection and treatment, emphasizing a multidisciplinary approach for better patient outcomes in SSc cardiac disease.
Area of Science:
- Cardiology
- Rheumatology
- Systemic Sclerosis
Background:
- Cardiac disease is a significant complication of systemic sclerosis (SSc), associated with poor prognosis.
- Limited evidence exists on optimal detection and management strategies for cardiac disease in SSc patients.
Framework:
- Development of a consensus best practice pathway for cardiac disease management in SSc.
- Informed by a comprehensive literature review and expert multidisciplinary task force.
Implementation:
- Presents a pathway for early detection and management of primary cardiac disease in SSc.
- Recommends standard pharmacological and device therapies.
- Advocates for shared care and a multidisciplinary team approach.
Implications:
- Provides a reference for physicians managing SSc patients.
- Highlights the need for further research into the natural history of primary cardiac disease in SSc.
- Emphasizes the importance of collaboration between rheumatologists and cardiologists.
Objective:
Cardiac disease in SSc can manifest in various ways and is associated with a poor prognosis. There is little evidence on how best to detect and manage cardiac disease in SSc. Our objective was to produce an expert consensus best practice pathway for the management of cardiac disease in SSc.
Methods:
The UK Systemic Sclerosis Study Group set up several working groups to develop a number of consensus best practice pathways for the management of SSc-specific complications, including cardiac disease. A multidisciplinary task force was convened. The guidelines were partly informed by a comprehensive literature review.
Results:
A best practice pathway for cardiac disease (with a focus on primary cardiac disease) in SSc is presented, including approaches for early detection and standard pharmacological and device therapies. Due to the benefits, shared care and a multidisciplinary approach are recommended. A future research agenda has been formulated in response to the relative lack of understanding of the natural history of primary cardiac disease that was highlighted by the initiative.
Conclusion:
The physician should be alert to the possibility of cardiac disease in SSc; it is best managed within a multidisciplinary team including both rheumatologists and cardiologists. This pathway provides a reference for all physicians managing patients with SSc.