Imaging Modalities Related to Cardiac Involvement in Systemic Sclerosis

Area of Science:

• Rheumatology
• Cardiology
• Medical Imaging

Background:

• Systemic sclerosis (SSc) is a severe rheumatic disease with high mortality.
• Cardiac involvement is common in SSc but often overlooked, preceding diagnosis.
• Pulmonary and cardiac complications are primary causes of death in SSc patients.

Purpose of the Study:

• To highlight the significance of cardiac involvement in Systemic Sclerosis.
• To evaluate the role of imaging biomarkers, particularly cardiac magnetic resonance (CMR), in detecting early cardiac changes in SSc.
• To emphasize the need for improved monitoring and diagnostic strategies for SSc-related heart disease.

Main Methods:

• Review of current literature on SSc pathophysiology and cardiac manifestations.
• Comparison of echocardiography (including strain imaging) and CMR for assessing cardiac function and structure.
• Discussion of CMR's unique ability to detect myocardial inflammation, fibrosis, and microvascular disease.

Main Results:

• Echocardiography provides functional data and estimates pulmonary artery pressure.
• Strain echocardiography and CMR feature tracking can identify early systolic dysfunction.
• CMR offers comprehensive assessment, detecting myocardial changes and coronary microvascular disease before functional decline.

Conclusions:

• Cardiac involvement in SSc requires careful monitoring using advanced imaging biomarkers.
• CMR is a powerful tool for early detection of myocardial inflammation, fibrosis, and microvascular disease in SSc.
• Further multicenter studies are needed to establish CMR's role in SSc patient management and guideline development.