Heart involvement in systemic sclerosis.

Area of Science:

• Cardiology
• Rheumatology
• Internal Medicine

Background:

• Cardiac involvement in systemic sclerosis (ScS) significantly predicts mortality.
• Early detection and evaluation of cardiac complications are crucial for ScS management.

Purpose of the Study:

• To investigate cardiac manifestations in 30 ScS patients using echocardiography, tissue Doppler imaging, 6-minute walk test (6MWT), and BNP levels.
• To establish a strategy for detecting and evaluating cardiac complications in ScS.

Main Methods:

• A cross-sectional study of 30 consecutive ScS patients diagnosed per ACR/EULAR 2013 criteria.
• Cardiac assessment included standard echocardiography with pulsed-tissue Doppler imaging, 6MWT, and BNP level measurement.
• Statistical analysis correlated findings with clinical and serological parameters.

Main Results:

• Left ventricular systolic dysfunction (LVSD) found in 40% of patients, associated with diffuse ScS, Scl70 antibodies, and interstitial lung disease.
• Left ventricular diastolic dysfunction (LVDD) correlated with hypertension, diffuse ScS, telangiectasia, and pulmonary hypertension.
• Elevated systolic pulmonary arterial pressure (PAPs) and BNP levels were noted in patients with right ventricular systolic dysfunction (RVSD).
• Elevated PAPs correlated with accelerated pulse, cough, dyspnea, shorter 6MWD, higher Borg score, and elevated BNP.
• BNP levels and 6MWT demonstrated sensitivity and specificity in detecting elevated PAPs.

Conclusions:

• Left ventricular diastolic impairment was the most frequent echocardiographic abnormality.
• BNP levels and 6MWT are valuable, sensitive, and specific tools for detecting elevated pulmonary arterial pressure in ScS.
• These non-invasive methods can aid in the early detection and evaluation of cardiac complications in systemic sclerosis.