Heart and systemic sclerosis-findings from a national cohort study

Area of Science:

• Cardiology
• Rheumatology
• Epidemiology

Background:

• Cardiac involvement is a leading cause of death in Systemic Sclerosis (SSc).
• The prevalence and prognostic impact of SSc-related heart disease are not well-established.
• Understanding these factors is crucial for patient management and outcomes.

Purpose of the Study:

• To investigate the prevalence and prognosis of SSc-related cardiac involvement.
• To determine the incidence and risk factors of heart diseases in a nationwide SSc cohort.
• To analyze the survival impact of various cardiac conditions in SSc.

Main Methods:

• Utilized data from a multicentric prospective study of the French SSc national database.
• Focused on identifying SSc-related cardiac involvement, its incidence, and associated risk factors.
• Conducted survival analyses on a cohort of SSc patients with and without cardiac involvement.

Main Results:

• 10.9% of 3528 SSc patients had cardiac involvement at baseline, associated with diffuse subtype and cardiovascular risk factors.
• SSc-related cardiac involvement increased the risk of death; no significant survival difference was noted between SSc-related cardiac involvement, ischemic heart disease, or pulmonary arterial hypertension.
• 5-year event rates: 11.15% for SSc-related cardiac involvement, 2.49% for reduced LVEF, 5.84% for diastolic dysfunction, and 3% for pericarditis. Diffuse SSc subtype was a risk factor for SSc-related cardiac involvement and pericarditis; female sex was linked to less diastolic dysfunction.

Conclusions:

• This large-scale study clarifies the incidence and prognostic burden of SSc-related cardiac involvement.
• Diffuse SSc subtype and female sex are identified as significant risk factors for specific cardiac outcomes.
• Further research is needed to evaluate the impact of treatments on cardiac outcomes in SSc.