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Diastolic Dysfunction in Systemic Sclerosis: Risk Factors and Impact on Mortality
Alicia M Hinze1, Jamie Perin2, Adrianne Woods3
1Mayo Clinic, Rochester, Minnesota.
Arthritis & Rheumatology (Hoboken, N.J.)
|December 20, 2021
Summary
Diastolic dysfunction (DD) is a significant risk factor for mortality in systemic sclerosis (SSc) patients. Addressing modifiable risks like coronary artery disease and obesity may reduce SSc mortality.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Systemic sclerosis (SSc) is a complex autoimmune disease with significant cardiovascular implications.
- Diastolic dysfunction (DD) is a recognized complication, but its independent risk factors and impact on mortality in SSc require further elucidation.
Purpose of the Study:
- To identify independent risk factors for developing diastolic dysfunction (DD) in patients with systemic sclerosis (SSc).
- To evaluate the impact of DD on overall mortality in the SSc patient population.
Main Methods:
- A cohort of 806 SSc patients with available echocardiograms was analyzed.
- Logistic regression identified DD risk factors, while Cox proportional hazards models assessed survival.
- Prospective data collection included SSc disease characteristics and clinical risk factors.
Main Results:
- Diastolic dysfunction (DD) was present in 18.6% of SSc patients.
- Independent risk factors for DD included older age, coronary artery disease, obesity, longer SSc duration, reduced diffusing capacity for carbon monoxide, and history of scleroderma renal crisis.
- Anti-Scl-70 positivity and severe gastrointestinal disease were associated with reduced DD risk.
- DD independently increased the risk of mortality (HR 1.69).
Conclusions:
- Diastolic dysfunction (DD) is an independent predictor of increased mortality in patients with systemic sclerosis (SSc).
- Targeting modifiable risk factors such as coronary artery disease and obesity is crucial for mitigating mortality risk in SSc patients.
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