Systemic sclerosis & Raynaud's
The Gut–Heart Axis in Systemic Sclerosis: Evidence From a Large Prospective Early Disease Cohort
Main finding · Cardiac involvement predicted by baseline malabsorptionResult — go to the resultHazard ratio 10.01 95% CI 3.7–26.9Authors' conclusion
Upper GI dysfunction was associated specifically with conduction defects, suggesting that autonomic dysfunction contributes. In contrast, lower GI involvement, particularly malabsorption, was linked to systolic dysfunction in patients with SSc, potentially indicating a distinct biologic mechanism.
Study context
- Population
- Patients with early systemic sclerosis (SSc) in the prospective Genetics versus Environment in Scleroderma Outcomes Study cohort (82% female)median follow-up 4.1 years
- Participants
- 459 patients
- Exposure
- Baseline gastrointestinal (GI) involvement vs no GI involvement
- Outcome
- Future cardiac manifestations (conduction defects and systolic dysfunction)
Methodological detailsCox and multivariable logistic regression, adjusted for potential confounders
- Cox and multivariable logistic regression
- Adjusted for potential confounders
Main finding
As reported in the abstract
Cardiac involvement predicted by baseline malabsorption
Hazard ratio
10.01
95% CI 3.7–26.9
Baseline GI involvementvs no GI involvement
HR 10.01 (95% CI 3.7–26.9)
Observational data: associations, not effects.
Further findings
GI involvement at baseline
- Patients with GI involvement
- 59%
Cardiac manifestations during follow-up · median 4.1 years (IQR 0.8-8.1)
- Any cardiac manifestation
- 26%
- Conduction defects
- 24%
- Systolic dysfunction
- 5%
Specific GI symptoms and cardiac manifestation type
- Dysphagia and peptic ulcers significantly associated with conduction defects
- Malabsorption significantly associated with systolic dysfunction
- Even after adjustment for potential confounders
Original publication
The Gut–Heart Axis in Systemic Sclerosis: Evidence From a Large Prospective Early Disease Cohort. Arthritis Care Res (Hoboken). Published 1 June 2026. doi:10.
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