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Heart disease in the course of systemic sclerosis - an observational study
Anna Nowakowska-Płaza1, Jakub Wroński1, Joanna Werońska-Tatara1
1Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Insights
Systemic sclerosis (SSc) can significantly impact the heart, with myocarditis being a common complication. Male gender, diffuse SSc, and skin score are identified as risk factors for cardiac involvement, highlighting the need for early screening.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Cardiac involvement is a major cause of mortality in systemic sclerosis (SSc).
- Understanding the clinical characteristics and risk factors of cardiac involvement in SSc is crucial for patient management.
Purpose of the Study:
- To compare the clinical characteristics of SSc patients with and without heart involvement.
- To identify risk factors associated with cardiac complications in SSc.
Main Methods:
- Observational study analyzing electronic medical records of SSc patients from January 2021 to August 2022.
- Comparison of clinical characteristics between SSc patients with and without diagnosed heart disease.
Main Results:
- Seven out of 36 SSc patients had cardiac involvement, primarily myocarditis (71%).
- Elevated troponin and NT-proBNP levels, diastolic heart failure, and supraventricular extrasystoles were common findings.
- Risk factors included male gender, diffuse SSc, higher modified Rodnan skin score, gastrointestinal involvement, and myositis.
Conclusions:
- Cardiac involvement is a significant concern in SSc patients.
- Early screening for heart disease is essential in this patient population.
Introduction:
Cardiac involvement is one of the major mortality factors in systemic sclerosis (SSc). This observational study aimed to compare patients with and without heart involvement in the course of SSc.
Material And Methods:
Electronic medical records of patients treated between January 2021 and August 2022 in the Department of Rheumatology were searched for the diagnosis of SSc (ICD-10 code M47). The clinical characteristics of patients with and without heart involvement in the course of SSc were compared.
Results:
Out of 36 patients with SSc, 7 patients were diagnosed with heart disease in the course of SSc. The major type of cardiac involvement was myocarditis (71%). The majority of patients with heart involvement had elevated troponin (86%) and NT-proBNP (71%) concentrations. The most common finding observed in echocardiography was diastolic failure (71%). The most frequent abnormality found in 24-hour Holter ECG was isolated supraventricular extrasystoles (100%). Risk factors for developing heart disease in the course of SSc were male gender (p = 0.018), diffuse type of SSc (p = 0.03), higher values of modified Rodnan skin score (p < 0.001), gastrointestinal tract involvement (p = 0.027) and myositis (p = 0.018).
Conclusions:
Optimal screening for heart disease is needed in this group of patients.
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