Subclinical Systemic Sclerosis Primary Heart Involvement by Cardiovascular Magnetic Resonance Shows No Significant...

Area of Science:

• Cardiology
• Rheumatology
• Medical Imaging

Background:

• Subclinical cardiac involvement is common in systemic sclerosis (SSc).
• The long-term progression of these subclinical cardiac findings in SSc is not well understood.
• Cardiovascular magnetic resonance (CMR) offers detailed cardiac assessment.

Purpose of the Study:

• To investigate the interval changes in subclinical cardiac involvement in patients with systemic sclerosis (SSc) using CMR.
• To assess the progression of cardiac abnormalities over time in SSc patients without diagnosed cardiovascular disease.

Main Methods:

• Prospective study involving 31 SSc patients without cardiovascular disease.
• Two CMR scans were performed, including T1 mapping and quantitative stress perfusion.
• Changes in CMR measures and associations with clinical phenotype were analyzed.

Main Results:

• Four patients showed focal late gadolinium enhancement (LGE) at baseline; one had increased scar mass, and two developed new LGE over follow-up (median 33 months).
• Reduced lung function (vital capacity, total lung capacity) correlated with decreased left ventricular ejection fraction and myocardial perfusion reserve (MPR).
• Increased N-terminal pro-brain natriuretic peptide levels were associated with reduced MPR; DMARDs use correlated with increased native T1.

Conclusions:

• Serial CMR can detect interval progression of subclinical cardiac involvement in SSc.
• However, cardiac abnormalities in SSc patients largely remain stable during the follow-up period.
• Findings suggest a need for continued monitoring of cardiac status in SSc.