Prognostic role of echocardiography to predict cardiovascular involvement in systemic sclerosis

Abstract Funding Acknowledgements Type of funding sources: None. Purpose. Cardiovascular involvement in systemic sclerosis (SSc) is frequent, often subtle, and associated with poor prognosis. Our aim was to compare echocardiographic data SSc patients controls, assess parameters able predict the development cardiovascular involvement. Methods. We enrolled 756 (Group 1) without a previous diagnosis cardiac nor pulmonary arterial hypertension (PAH), 614 healthy controls 2) matched for age 1 54.9 ± 14.6 years vs Group 2 54.4 12.1, p = 0.6), sex (7.3% 7.2%, 0.8), prevalence (17.8% 19.8%, 0.2). All subjects underwent comprehensive transthoracic 2D Doppler echocardiography, including tissue imaging analysis (TDI). Five hundred two were followed-up PAH, left-sided heart failure (LHF), right-sided (RHF), need implantable cardioverter defibrillator (ICD) considered as events. Results. Compared showed worse left right ventricular systolic diastolic function, hemodynamics ventricle-arterial coupling (tricuspid annulus plane excursion over artery pressure, TAPSE/sPAP) (Table). After median follow-up 35 moths, 45 composite events (PAH, LVH, RHF ICD) occurred. In multivariate model, only ejectioin fraction (EF) TAPSE/sPAP had independent prognostic value Conclusions. overt no PAH display subtle impairments biventricular systo-diastolic function coupling. Left EF can further Descriptive Cox regression Univariate Multivariate VARIABLE (Ssc) n (controls) HR (95 % CI) (95% Ejection (%) 63 5.7 63.7 5.9 0.038 0.94 (0.88 - 0.99) 0.024 0.91 (0.85 0.98) 0.017 E/A 1.0 0.46 1.2 0.51 <0.0001 1.41 (0.77 2.58) 0.26 e’ mean (mm) 10.7 3 11.2 3.4 0.034 0.87 (0.76 (0.87 1.17) 0.902 atrial volume index (mL/m2) 26.5 7.7 21.3 6.7 1.03 (0.98 1.1) 0.24 TAPSE 22.1± 23.3± 0.89 (0.81 0.97) 0.012 sPAP (mmHg) 24.7± 22.3± 1.07 (1.04 < 0.0001 (mm/mmHg) 0.98 0.96 1.1 0.39 0.036 (0.009 0.141) 0.03 (0.004 0.19) Pericardial effusion 57 (7.5%) 0 (0%) 1.10 (0.38 3.15 ) 0.85