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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
PubMed

Insights

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.

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.
Abstract

Keywords:
diastolic dysfunctionechocardiographymortalitysystemic sclerosis

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