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Cardiac magnetic resonance predicts ventricular arrhythmias in scleroderma: the Scleroderma Arrhythmia Clinical

Sophie Mavrogeni1, Luna Gargani2, Alessia Pepe3

  • 1Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.

Rheumatology (Oxford, England)
|November 26, 2019
PubMed

Insights

A new SAnCtUS score using cardiovascular magnetic resonance (CMR) can predict dangerous heart rhythm disturbances in systemic sclerosis (SSc) patients. This score aids in identifying high-risk individuals for better management of cardiac events.

Area of Science:

  • Cardiology
  • Rheumatology
  • Medical Imaging

Background:

  • Cardiac rhythm disturbances are the leading cause of cardiovascular death in systemic sclerosis (SSc).
  • Current risk stratification for SSc patients does not incorporate electrocardiographic findings.
  • There is a need for improved methods to predict arrhythmias in SSc.

Purpose of the Study:

  • To translate 24-hour Holter findings into a risk prediction score using cardiovascular magnetic resonance (CMR).
  • To develop a tangible scoring system for identifying SSc patients at high risk of ventricular rhythm disturbances.

Main Methods:

  • Prospective multicentre study (SAnCtUS) of 150 SSc patients.
  • Assessment using 24-hour Holter and CMR, including ventricular function, oedema (T2 ratio), and late gadolinium enhancement (%LGE).
  • Development of the SAnCtUS score via decision-tree analysis based on T2 ratio and %LGE.

Main Results:

  • T2 ratio and %LGE were significant predictors of ventricular rhythm disturbances.
  • The SAnCtUS score, a four-category system, effectively identified patients at high risk.
  • A highest SAnCtUS score (4) was independently associated with a higher risk of the combined endpoint (sustained ventricular tachycardia or sudden cardiac death).

Conclusions:

  • T2 ratio and %LGE are valuable independent predictors of rhythm disturbances in SSc.
  • The SAnCtUS score provides a novel tool for risk stratification in SSc patients.
  • This score can aid in identifying patients who may benefit from closer cardiac monitoring and intervention.
Abstract

Keywords:
cardiovascular magnetic resonancerhythm disturbancesclerodermasudden cardiac deathsystemic sclerosis

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