Myocardial Disease in Systemic Sclerosis: Recent Updates and Clinical Implications

Abstract

Purpose of review: The present review aims to address systemic sclerosis (SSc)-associated myocardial disease, a significant cause of morbidity and mortality, by examining the mechanisms of inflammation, microvascular dysfunction, and fibrosis that drive cardiac involvement. The objective is to elucidate critical risk factors and explore advanced diagnostic tools for early detection, enhancing patient outcomes by identifying those at highest risk.

Recent findings: Recent studies underscore the importance of specific autoantibody profiles, disease duration, and cardiovascular comorbidities as key risk factors for severe cardiac manifestations in SSc. Additionally, advanced imaging techniques and biomarker analyses have emerged as pivotal tools for early identification and risk stratification. These innovations enable clinicians to detect subclinical myocardial involvement, potentially averting progression to symptomatic disease. SSc-associated myocardial disease remains challenging to predict, yet novel imaging modalities and biomarker-guided strategies offer a promising pathway for early diagnosis and targeted intervention. Integrating these approaches may enable more effective early detection and screening strategies as well as mitigation of disease progression, ultimately enhancing clinical outcomes for patients with SSc at-risk for adverse clinical outcomes.

Keywords: Biomarkers; Cardiac disease; Echocardiography; Systemic sclerosis.

Central Illustration:. Cardiac Manifestations in Systemic Sclerosis.

This central illustration highlights the diverse cardiac complications observed in systemic sclerosis. Abbreviations: COPD=chronic obstructive pulmonary disease, LV=left ventricle.