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Cardiac involvement in systemic sclerosis: Getting to the heart of the matter

Cosimo Bruni1, Laura Ross2

  • 1Department of Experimental Medicine, Division of Rheumatology, University of Florence, Via Delle Oblate 4, 50141, Florence, Italy.

Best Practice & Research. Clinical Rheumatology
|March 19, 2021
PubMed

Insights

Systemic sclerosis heart involvement (pSHI) often presents subtly, leading to significant mortality. Early detection of pSHI in systemic sclerosis (SSc) patients is crucial for timely intervention and preventing heart failure progression.

Area of Science:

  • Cardiology
  • Rheumatology
  • Internal Medicine

Background:

  • Primary systemic sclerosis heart involvement (pSHI) contributes significantly to mortality in systemic sclerosis (SSc).
  • pSHI presents a wide clinical spectrum, from subclinical abnormalities to severe heart failure.
  • Subclinical cardiac disease is increasingly recognized in SSc patients due to advanced diagnostic tools.

Purpose of the Study:

  • To highlight the challenges in early identification and diagnosis of pSHI.
  • To emphasize the potential for early intervention to prevent heart failure progression.
  • To underscore the need for improved screening and treatment guidelines for pSHI.

Main Methods:

  • Review of current literature on systemic sclerosis (SSc) and cardiac involvement.
  • Analysis of the clinical spectrum and diagnostic challenges of primary systemic sclerosis heart involvement (pSHI).
  • Discussion of the implications of subclinical cardiac disease in SSc.

Main Results:

  • Early signs of pSHI are often subtle and difficult to distinguish from other cardiomyopathies.
  • A significant burden of subclinical cardiac disease exists in SSc patients.
  • Current screening and treatment guidelines for pSHI are lacking.

Conclusions:

  • Early identification of pSHI is critical for intervention and preventing heart failure.
  • Distinguishing pSHI from other cardiac conditions like hypertension and IHD remains a challenge.
  • Further clinical research is essential to develop optimal screening and treatment strategies for pSHI.

Keywords:
Cardiac diseaseHeart involvementOrgan involvementSystemic sclerosis (scleroderma)

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