Systemic sclerosis & Raynaud's
Prognostic and functional importance of both overt and subclinical left ventricular systolic dysfunction in systemic sclerosis
Authors' conclusion
Both overt and subclinical SSc-associated LV dysfunction are associated with worse survival and impaired physical function.
Study context
- Population
- Australian Scleroderma Cohort Study participants meeting ACR/EULAR criteria for systemic sclerosis (SSc) with ≥1 echocardiographic LV ejection fraction (LVEF) measurement; secondary causes of LV dysfunction excludedLV-GLS at one centre, n = 218
- Participants
- 1,141 participants
- Exposure
- Overt or subclinical LV dysfunction vs none
- Outcome
- Frequency and clinical implications of SSc-associated LV function impairment
Methodological detailsAustralian Scleroderma Cohort Study, generalised estimating equations (GEE) longitudinal modelling, Kaplan-Meier and Cox proportional hazard models
- Australian Scleroderma Cohort Study
- GEE longitudinal modelling
- Kaplan-Meier and Cox proportional hazard models
Main finding
As reported in the abstract
Frequency of LV dysfunction
Ever recorded LVEF<50 %
2.4 %
Ever recorded LVEF≤40 %
0.6 %
Impaired LV-GLS despite LVEF≥50 % (n = 218)
21 %
Observational data: associations, not effects.
Further findings
Mortality, impaired LV-GLS (univariable)
| HR for death (95 % CI) | P value | ||
|---|---|---|---|
| Impaired LV-GLSUnivariable analyses | 3.4 (1.0–11.8) | P = 0.05 | |
| 0.050.21520HR for death (log scale) |
WHO Class III/IV dyspnoea, LVEF<50 %
| OR (95 % CI) | P value | ||
|---|---|---|---|
| LVEF<50 % | 3.5 (1.6–7.7) | P < 0.01 | |
| 0.10.31310Odds ratio (log scale) |
WHO Class III/IV dyspnoea, impaired LV-GLS
| OR (95 % CI) | P value | ||
|---|---|---|---|
| Impaired LV-GLS | 3.6 (1.4–9.2) | P < 0.01 | |
| 0.10.31310Odds ratio (log scale) |
Impaired LV-GLS (LV-GLS>−16 %) despite LVEF≥50 %
- Impaired LV-GLS despite LVEF≥50 %
- 21 %
- LV-GLS data available for 90 % of participants at one centre (n = 218)
Physical function, LVEF<50 %
- Shorter six-minute walk distance
- P = 0.01
- Higher HAQ-DI scores
- P < 0.01
- Lower Short Form-36 Physical Component Summary scores
- P = 0.02
Original publication
Prognostic and functional importance of both overt and subclinical left ventricular systolic dysfunction in systemic sclerosis. Semin Arthritis Rheum. Published 6 April 2024. doi:10.
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