■心脏受累是系统性硬化症的常见问题。最近,已经提出了系统性硬化症原发性心脏受累的定义.我们的目的是建立关于筛查的共识指导,系统性硬化症原发性心脏病患者的诊断和随访。
■进行了系统文献综述,以研究用于评估系统性硬化症患者心脏受累的测试。提取的数据被分类到相关领域(传统放射学,心电图,超声心动图,心脏磁共振成像,实验室,和其他),并提交给专家和一名患者研究伙伴,他们讨论了数据并补充了他们的意见。这导致制定了总体原则和指导声明,然后审查并投票同意。当平均协议是7/10和70%的选民达成共识时,达成了共识。
■在2650种出版物中,168人符合资格标准;提取的数据在三次会议上进行了讨论。创建了7项总体原则和10个指导点,修改并投票。共识强调了患者咨询的重要性,鉴别诊断和多学科团队管理,以及定义筛查和诊断方法。初步的核心评价要结合历史,体检,休息心电图,经胸超声心动图和标准血清心脏生物标志物。进一步的调查应单独定制,并通过多学科管理来决定。总体平均一致为9.1/10,平均93%的专家投票超过7/10。
■这份基于共识的筛查指南,系统性硬化症原发性心脏受累的诊断和随访为标准护理和未来可行性研究奠定了基础,这些研究正在进行中,以支持其在临床实践中的应用.
UNASSIGNED: Heart involvement is a common problem in systemic sclerosis. Recently, a definition of systemic sclerosis primary heart involvement had been proposed. Our aim was to establish
consensus guidance on the screening, diagnosis and follow-up of systemic sclerosis primary heart involvement patients.
UNASSIGNED: A systematic literature review was performed to investigate the tests used to evaluate heart involvement in systemic sclerosis. The extracted data were categorized into relevant domains (conventional radiology, electrocardiography, echocardiography, cardiac magnetic resonance imaging, laboratory, and others) and presented to experts and one patient research partner, who discussed the data and added their opinion. This led to the formulation of overarching principles and guidance statements, then reviewed and voted on for agreement.
Consensus was attained when the mean agreement was ⩾7/10 and of ⩾70% of voters.
UNASSIGNED: Among 2650 publications, 168 met eligibility criteria; the data extracted were discussed over three meetings. Seven overarching principles and 10 guidance points were created, revised and voted on. The
consensus highlighted the importance of patient counseling, differential diagnosis and multidisciplinary team management, as well as defining screening and diagnostic approaches. The initial core evaluation should integrate history, physical examination, rest electrocardiography, trans-thoracic echocardiography and standard serum cardiac biomarkers. Further investigations should be individually tailored and decided through a multidisciplinary management. The overall mean agreement was 9.1/10, with mean 93% of experts voting above 7/10.
UNASSIGNED: This
consensus-based guidance on screening, diagnosis and follow-up of systemic sclerosis primary heart involvement provides a foundation for standard of care and future feasibility studies that are ongoing to support its application in clinical practice.