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Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs

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Left Ventricular Diastolic Dysfunction Predicts Mortality in Patients With Systemic Sclerosis.

Anders H Tennøe¹, Klaus Murbræch², Johanna C Andreassen²

¹Department of Rheumatology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Journal of the American College of Cardiology

|October 6, 2018

Summary

Diastolic dysfunction (DD) is common in systemic sclerosis (SSc) and significantly increases mortality risk. This cardiac issue is a stronger predictor of death than pulmonary hypertension (PH) in SSc patients.

Keywords:

diastolic dysfunction echocardiography mortality systemic sclerosis

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Area of Science:

Cardiology
Rheumatology
Pulmonology

Background:

Primary cardiac affection is a significant cause of mortality in systemic sclerosis (SSc).
Knowledge gaps exist regarding the impact of cardiac dysfunction on SSc patient survival.

Purpose of the Study:

To evaluate diastolic function in a large, unselected SSc cohort.
To assess the effect of diastolic dysfunction (DD) on mortality in SSc patients.

Main Methods:

Prospective follow-up of 275 SSc patients and matched controls from 2003-2016.
Diastolic dysfunction (DD) assessed by echocardiography; pulmonary hypertension (PH) diagnosed by right heart catheterization.
Cox regression analyses used to determine mortality predictors.

Main Results:

At baseline, 17% of SSc patients had DD, increasing to 29% at follow-up.
57% of patients with baseline DD died, versus 13% with normal diastolic function.
DD was a stronger mortality predictor (HR: 3.7) than PH (HR: 2.0).

Conclusions:

Diastolic dysfunction (DD) is frequent in systemic sclerosis (SSc).
Presence of DD is strongly associated with high mortality in SSc.
DD is a more potent predictor of mortality than PH in SSc.