Prevalence and factors associated with left ventricular dysfunction in the EULAR Scleroderma Trial and Research group (EUSTAR) database of patients with systemic sclerosis

Abstract

OBJECTIVES: To measure the prevalence of, and factors associated with, left ventricular (LV) dysfunction in systemic sclerosis (SSc). METHODS: The EUSTAR database was first searched. A casecontrol study of a patient subset was then performed to further identify independent factors associated with LV dysfunction by simple and multiple regression. RESULTS: Of 7073 patients, 383 (5.4%) had an LV ejection fraction (EF) of <55%. By multiple regression analysis, age, sex, diffuse cutaneous disease, disease duration, digital ulcerations, renal and muscle involvement, disease activity score, pulmonary fibrosis and pulmonary arterial hypertension were associated with LV dysfunction. In the second phase, 129 patients with SSc with LVEF <55% were compared with 256 patients with SSc with normal LVEF. Male sex (OR 3.48; 95% CI 1.74 to 6.98), age (OR 1.03; 95% CI 1.01 to 1.06), digital ulcerations (OR 1.91; 95% CI 1.05 to 3.50), myositis (OR 2.88; 95% CI 1.15 to 7.19) and use of calcium channel blockers (OR 0.41; 95% CI 0.22 to 0.74) were independent factors associated with LV dysfunction. CONCLUSION: The prevalence of LV dysfunction in SSc is 5.4%. Age, male gender, digital ulcerations, myositis and lung involvement are independently associated with an increased prevalence of LV dysfunction. Conversely, the use of calcium channel blockers may be protective. Prevalence and factors associated with left ventricular dysfunction in the EULAR Scleroderma Trial and Research group (EUSTAR) database of systemic sclerosis patientsAllanore Y (1), Meune C (2), Vonk MC (3), Airo P (4), Hachulla E (5), Caramaschi P (6), Riemekasten G (7), Cozzi F(8), Beretta L (9), Derk CT (10) AbstractStudy objectives and methods To measure the prevalence of, and factors associated with, left ventricular (LV) dysfunction in SSc, we first queried the EUSTAR database. In a second phase, we performed a case-control study of a patient subset, to further identify independent factors associated with LV dysfunction by simple and multiple regression. Results Among 7,073 patients, 383 (5.4%) had a LV ejection fraction (EF) <55%. By multiple regression analysis, age, sex, diffuse cutaneous disease, disease duration, digital ulcerations, renal and muscle involvement, disease activity score, pulmonary fibrosis and pulmonary arterial hypertension (PAH) were associated with LV dysfunction. In a second phase, 129 SSc patients with LVEF <55% were compared with 256 SSc patients with normal LVEF. Male sex (OR 3.48; 95% CI1.74-6.98), age (OR 1.03; 95% CI 1.01-1.06), digital ulcerations (OR 1.91; 95% CI 1.05-3.50), myositis (OR 2.88; 95% CI 1.15-7.19), and calcium channel blockers (CCB) use (OR 0.41; 95% CI 0.22-0.74) were independent factors associated with LV dysfunction.

Autoimmune myocarditis in systemic sclerosis: an unusual form of scleroderma heart disease presentation

“…Depressed LV contractility is among the rarest findings in SSc patients, with an estimated prevalence between 1–5%,9 and its prognostic significance has never been evaluated. More often (in about 40% of the cases), patients present with relaxation abnormalities, valvular regurgitation, and RV pathology 10.…”

The Main Results of Cooperation Between the V.A. Nasonova Research Institute of Rheumatology and Research Centers of Europe Within the Eustar (Eular Scleroderma Trials and Research Group) in Systemic Sclerosis

“…В одном из проектов были проанализированы ре-зультаты базы данных, связанные с наличием дисфункции левого желудочка (ЛЖ) [11]. В исследование было включе-но 7073 больных ССД.…”

A right ventricular diastolic impairment is common in systemic sclerosis and is associated with other target-organ damage

“…The prevalence of cardiac involvement varies dramatically between studies, ranging from 5% to near 100%, depending on the studied population, the study sample size and the tool used for assessment [1][2][3][4][5]. However, it is a poor prognostic factor according to a recent meta-analysis [6].…”