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Cardiovascular outcomes in systemic sclerosis with abnormal cardiovascular MRI and serum cardiac biomarkers
- Source :
- RMD Open, Vol 7, Iss 3 (2021), RMD Open
- Publication Year :
- 2021
- Publisher :
- BMJ Publishing Group, 2021.
-
Abstract
- ObjectivesTo explore the prognostic value of subclinical cardiovascular (CV) imaging measures and serum cardiac biomarkers in systemic sclerosis (SSc) for the development of CV outcomes of primary heart involvement (pHI).MethodsPatients with SSc with no clinical SSc-pHI and no history of heart disease underwent cardiovascular magnetic resonance (CMR) imaging, and measurement of serum high-sensitivity-troponin I (hs-TnI) and N-terminal-pro-brain natriuretic peptide (NT-proBNP). Follow-up clinical and CV outcome data were recorded. CV outcomes were defined as myocarditis, arrhythmia and/or echocardiographic functional impairment including systolic dysfunction and/or diastolic dysfunction.ResultsSeventy-four patients with a median (IQR) age of 57 (49, 63) years, 32% diffuse cutaneous SSc, 39% interstitial lung disease, 30% Scl70+ were followed up for median (IQR) 22 (15, 54) months. Ten patients developed CV outcomes, comprising one patient with myocarditis and systolic dysfunction and nine arrhythmias: three non-sustained ventricular tachycardia and six supraventricular arrhythmias. The probability of CV outcomes was considerably higher in those with NT-proBNP >125 pg/mL versus normal NT-proBNP (X2=4.47, p=0.035). Trend for poorer time-to-event was noted in those with higher extracellular volume (ECV; indicating diffuse fibrosis) and hs-TnI levels versus those with normal values (X2=2.659, p=0.103; X2=2.530, p=0.112, respectively). In a predictive model, NT-proBNP >125 pg/mL associated with CV outcomes (OR=5.335, p=0.040), with a trend observed for ECV >29% (OR=4.347, p=0.073).ConclusionThese data indicate standard serum cardiac biomarkers (notably NT-proBNP) and CMR indices of myocardial fibrosis associate with adverse CV outcomes in SSc. This forms the basis to develop a prognostic model in larger, longitudinal studies.
- Subjects :
- medicine.medical_specialty
Myocarditis
Heart disease
medicine.drug_class
Immunology
Diastole
Systemic Sclerosis
Ventricular tachycardia
Rheumatology
Internal medicine
medicine
Natriuretic peptide
Immunology and Allergy
Humans
scleroderma
cardiovascular diseases
Prospective Studies
Prospective cohort study
Scleroderma, Systemic
medicine.diagnostic_test
business.industry
Interstitial lung disease
Magnetic resonance imaging
Middle Aged
systemic
medicine.disease
Fibrosis
Magnetic Resonance Imaging
Cardiology
Medicine
business
Biomarkers
Subjects
Details
- Language :
- English
- ISSN :
- 20565933
- Volume :
- 7
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- RMD Open
- Accession number :
- edsair.doi.dedup.....d432d7607deee9f80cd96f65139759ca