Evaluation of Left Cardiac Chamber Function with Cardiac Magnetic Resonance and Association with Outcome in Patients with Systemic Sclerosis.
- Butcher SC
van Leuven SI
El Messaoudi S
de Vries-Bouwstra JK
Ajmone Marsan N
Rheumatology (Oxford, England)[Rheumatology (Oxford)] 2022 Apr 28. Date of Electronic Publication: 2022 Apr 28.
- Publication Date:
- Objective: This study aimed to determine whether lower values of feature-tracking cardiovascular magnetic resonance (CMR)-derived left atrial (LA) reservoir strain (LARS) and impaired left ventricular (LV) global longitudinal strain (GLS) were associated with the presence of symptoms and long-term prognosis in patients with systemic sclerosis (SSc).
Methods: A total of 100 patients (54[IQR 46-64] years, 42% male) with SSc who underwent CMR imaging at two tertiary referral centres were included. All patients underwent analysis of LARS and LV GLS using feature-tracking on CMR and were followed-up for the occurrence of all-cause mortality.
Results: The median LV GLS was -21.8% and the median LARS was 36%. On multivariable logistic regression, LARS (OR 0.964 per %, 95%CI 0.929-0.998, p = 0.049) was independently associated with New York Heart Association (NYHA) class II-IV heart failure symptoms. Over a median follow-up of 37 (21-62) months, a total of 24 (24%) patients died. Univariable Cox regression analysis demonstrated that LARS (HR 0.94 per %, 95%CI 0.91-0.97, P < 0.0001) and LV GLS (HR 1.10 per %, 95%CI 1.03- 1.17, P = 0.005) were associated with all-cause mortality, while LV ejection fraction was not. Likelihood ratio tests demonstrated that LARS provided incremental value over prognostically important clinical and imaging parameters, including late gadolinium enhancement.
Conclusion: In patients with SSc, LARS was independently associated with the presence of NYHA class II-IV heart failure symptoms. Although both LARS and LV GLS were associated with all-cause mortality, only LARS provided incremental value over all evaluated variables known to be prognostically important in patients with SSc.
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- Rheumatology (Oxford, England)
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