Atrial fibrillation in systemic sclerosis: a time-dependent factor?

Abstract Background Systemic sclerosis (SSc) is an autoimmune disease associated with widespread vasculopathy and progressive fibrosis of the skin internal organs. Cardiac involvement frequent, usually subclinical may involve all wall layers. Myocardial remodelling leads to electromechanical imparity, increasing vulnerability atrial fibrillation (AF). Unfortunately, little known about how long it takes for AF occur. New unicentric data are available. Purpose The aim our trial was map temporal component occurrence in SSc in- outpatients on standard care. Methods In a longitudinal retrospective analysis, we scoped aged 18 85 years ACR/EULAR score ≥9 presence AF. Next, excluded those or antiarrhythmic therapy prior diagnosis. To investigate impact AF, created Kaplan Meier curves Cox regression models using time from diagnosis first recorded as main outcome measurement. Also, comparison subgroups based status (no/yes) conducted. All were collected 12-lead ECGs, cardiac echoes e-health records. Results We enrolled 114 patients, including 96 (84.2%) women, who had median age at 50.47 (95% CI 48.00–53.00) years. ENA-testing revealed 39 (34.8%) anti-CENP-B 42 (37.5%) anti-Scl-70 positive samples. found 19 (16.7%) patients after follow-up 8.67 6.86–12.53) years, equalling 1.45 cases 0.88–2.26) per 100 patient-years. While body mass index (BMI) slightly elevated subjects, both left (LAVI) right volume (RAVI) showed normal values. Exposure pulmonary arterial hypertension (PAH) and/or (AH) present 32 (28.1%) 40 (35.1%) respectively. After 25 overall proportion event-free 51.6% 32.8–81.3), remaining 5 numbers risk. observed that contributed (HR 1.154; 95% 1.079–1.233; p<0.001). contrast, BMI, gender, LAVI, RAVI, PAH AH no significant effect Notable differences non-AF subgroup dimensions (LAVI: 26.44ml/m2; 22.51–33.01; p=0.001; RAVI: 30.47ml/m2; 21.92–34.98; p=0.006) increased (63.00yr; 53.57–66.62; p<0.001) subgroup. terms ENAs, time, BMI burden, they shared similar features. Conclusions common long-lasting SSc. reduce hazard early essential because its chronically fibrotic nature. hypothesize dilated atria indicate altered morphology being possible sign SSc-related microvascular ischemic disorders. Due limitations trials, further studies needed prove concept quantify real burden Funding Acknowledgement Type funding sources: None.