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Points to consider when doing a trial primarily involving the heart
Yannick Allanore1, Oliver Distler2, Ulrich A Walker3
1Department of Rheumatology A, Cochin Hospital and Cochin Institute, AP-HP, Paris-Descartes University, Paris, France.
Rheumatology (Oxford, England)
|October 10, 2017
Summary
Cardiac involvement significantly worsens systemic sclerosis (SSc) and requires careful monitoring. Early detection using various tools is crucial for managing this severe complication and improving patient prognosis.
Area of Science:
- Cardiology
- Rheumatology
- Systemic Sclerosis Research
Background:
- Cardiac involvement is a major determinant of severity and prognosis in systemic sclerosis (SSc).
- Subclinical cardiac issues are common, but symptomatic disease carries a poor outlook.
- Comprehensive assessment of cardiac structures and function is vital for SSc patients.
Purpose of the Study:
- To highlight the importance of investigating and managing cardiac complications in systemic sclerosis.
- To review the complementary diagnostic tools available for assessing cardiac involvement in SSc.
- To underscore the need for further research into effective treatments for cardiac issues in SSc.
Main Methods:
- Review of current diagnostic modalities for cardiac assessment in SSc.
- Discussion of the prognostic implications of cardiac involvement in SSc.
- Analysis of treatment strategies and the role of clinical trials.
Main Results:
- Multiple non-invasive tools (biomarkers, ECG, echocardiography, MRI) enable thorough cardiac evaluation in SSc.
- Symptomatic cardiac disease in SSc is associated with a poor prognosis.
- Current treatment approaches for cardiac complications in SSc are largely empirical.
Conclusions:
- Cardiac assessment is essential for all systemic sclerosis patients.
- A multi-tool approach aids in evaluating endocardial, myocardial, and pericardial involvement.
- Further cardiac clinical trials in SSc are needed to establish evidence-based treatments.