关键词: SSc-cardiomyopathy cardiac disease primary myocardial disease scleroderma systemic sclerosis

Mesh : Adolescent Adult Age of Onset Aged Aged, 80 and over Arrhythmias, Cardiac / diagnosis Cardiomyopathies / diagnosis mortality Child Diagnosis, Differential Echocardiography / methods Electrocardiography / methods Female Humans Magnetic Resonance Angiography Male Middle Aged Prognosis Quality of Life Scleroderma, Systemic / diagnosis mortality Severity of Illness Index Sex Factors Young Adult

来  源:   DOI:10.1093/rheumatology/kew364   PDF(Sci-hub)

Abstract:
Cardiac disease is prevalent in SSc and associated with a poor prognosis. Differentiating primary myocardial disease (SSc-cardiomyopathy) from ischaemic heart disease is difficult and the disease phenotype most at risk is unclear. A comprehensive literature review was performed to inform the UK Systemic Sclerosis Study Group for cardiac disease tasked with producing a best practice pathway for the management of cardiac disease in SSc. This review describes the prevalence of SSc-cardiomyopathy, its associated greater mortality and various manifestations (e.g. heart failure, arrhythmias and diastolic dysfunction). The limited evidence suggests SSc-cardiomyopathy is associated with other poor prognostic indicators, including diffuse cutaneous disease, positive SSc-specific serology, black ethnicity, older age at disease onset, tendon friction rubs, abnormal nail-fold capillaroscopy and worse quality-of-life scores. Differentiating SSc-cardiomyopathy from ischaemic heart disease requires well-planned studies. Non-invasive investigative techniques are improving the understanding of its pathophysiological basis.
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