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Subclinical myocardial involvement progresses in SSc patients

Presented by
Dr Devis Benfaremo, UniversitĂ  Politecnica delle Marche, Italy
EULAR 2020
Dr Devis Benfaremo (UniversitĂ  Politecnica delle Marche, Italy) described the progression of myocardial deformation in patients with systemic sclerosis (SSc) and no overt cardiac disease and found that global longitudinal strain (GLS) impairment progressed over a 20-month follow-up period in these patients [1].

This was the main finding of an Italian prospective longitudinal study, which included 72 SSc patients (68 female, mean age 56.6 years) who fulfilled the 2013 ACR/EULAR classification criteria for SSc. Patients with structural heart disease, heart failure, atrial fibrillation, or pulmonary hypertension were excluded from the study. An echocardiographic examination was performed for all patients at baseline and during their follow-up evaluation. Standard and speckle-tracking derived variables, including GLS, were acquired to assess systolic and diastolic function of the left (LV) and right ventricle (RV). Additional recorded data consisted of disease subset, antibodies pattern, cardiovascular risk factors, and involvement of other organ systems.

Common echocardiographic parameters of left and right systolic function were within normal range at baseline and did not change during follow-up. Mean GLS, however, worsened for both LV (from -19.8 ± 3.5% to -18.7 ± 3.5%; P=0.034) and RV (from -20.9 ± 6.1% to -18.7 ± 5.4%; P=0.013) during a median follow-up of 20 months. The increased GLS impairment registered in SSc patients was homogenous across endocardial, mesocardial, and epicardial layers of both ventricles, as well as myocardial segments. There was no difference in GLS impairment progression rate when patients were stratified according to disease subset or other clinical parameters. Dr Benfaremo urged that more studies are needed to assess the significance of subclinical heart involvement and its progression in patients with SSc.

  1. Benfaremo D, et al. Abstract SAT0307. EULAR E-Congress, 3-6 June 2020.


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