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Review
. 2024 Oct;44(10):1823-1836.
doi: 10.1007/s00296-024-05699-x. Epub 2024 Aug 27.

Heart involvement in patients with systemic sclerosis-what have we learned about it in the last 5 years

Aleksandra Nadel  1 , Maciej Nadel  2 , Nina Taborska  3 , Bartosz Stępień  3 , Jakub Gajdecki  3 , Olga Brzezińska  3 , Aleksandra Opinc-Rosiak  3 , Joanna Makowska  3 , Anna Lewandowska-Polak  3
Affiliations
Review

Heart involvement in patients with systemic sclerosis-what have we learned about it in the last 5 years

Aleksandra Nadel et al. Rheumatol Int. 2024 Oct.

Abstract

This review provides a detailed examination of original research and previously published reviews regarding cardiovascular involvement in systemic sclerosis (SSc). Our study aims to evaluate the current understanding of SSc-associated heart involvement (SHI), focusing on its most prevalent forms, diagnostic methods and treatment options. A comprehensive search of PUBMED, Medline, Web of science, Scopus and DOAJ databases was conducted, involving articles published between January 2019 and August 2024, available in English, both original research and reviews. Additionally, the authors examined the references cited in the selected articles, reviewed relevant literature, and included key publications dating back to 2010. Systemic Sclerosis (SSc) is an autoimmune connective tissue disease characterized by skin and internal organs fibrosis with accompanying vasculopathy. SHI encompasses both primary and secondary cardiac disease with a prevalence rate of up to 39%. It constitutes one of the leading causes of death among affected individuals. Systemic sclerosis- primary heart involvement comprises a wide range of conditions including arrhythmias, heart failure, pericardial disease, valvular abnormalities, and myocardial inflammation. However, its subclinical course, often misinterpreted as other forms of cardiomyopathy, poses true diagnostic challenges, requiring diagnostic tools like transthoracic echocardiography with tissue Doppler echocardiography and cardiac magnetic resonance imaging. The review underscores the importance of SHI and a holistic approach to managing patients with systemic sclerosis. Furthermore, it emphasizes the need for further investigation into potential pathogenetic mechanisms and biomarkers crucial for targeted treatment to fully optimize recommendations for this patient subgroup.

Keywords: Cardiac; Heart failure; Primary heart involvement; Systemic sclerosis.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
The most common manifestations of primary heart involvement in patients with systemic sclerosis
Fig. 2
Fig. 2
Screening and selection process
Fig. 3
Fig. 3
Resting and ambulatory ECG abnormalities among systemic sclerosis. RBBB right bundle branch block, LBBB left bundle branch block, NSVT non-sustained ventricular tachycardia, PVCs premature ventricular contractions, AF atrial fibrillation, SVT supraventricular tachycardia
See this image and copyright information in PMC

References

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