ArticleRheumatology (Oxford, England)2020
Cardiac magnetic resonance predicts ventricular arrhythmias in scleroderma: the Scleroderma Arrhythmia Clinical Utility Study (SAnCtUS).
Article in Rheumatology (Oxford, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Arrhythmias and Conduction Disturbances in Patients with Systemic Sclerosis-A Systematic Literature Review.International journal of molecular sciences · 2022Pooled it
- Position Statement on Multimodal Cardiac Imaging in Patients with Systemic Diseases - 2026.Arquivos brasileiros de cardiologia · 2026Article
- Coronary microvascular dysfunction in systemic sclerosis: insights from PET-derived myocardial flow reserve.Rheumatology (Oxford, England) · 2026Article
- Primary myocardial involvement in systemic sclerosis: pathophysiology, clinical manifestations and advances in cardiac imaging.Rheumatology (Oxford, England) · 2026Review
- Immunophenotypes and prognosis in autoimmune cardiovascular disease: a narrative review from clonal hematopoiesis to myocarditis, microvascular angina, and HFpEF.Annals of medicine and surgery (2012) · 2026Review
- Individualized care or standardized protocol: should all patients with systemic sclerosis receive cardiac MRI?Rheumatology (Oxford, England) · 2026Article
- Cardio-rheumatology: integrated care and the opportunities for personalized medicine.Therapeutic advances in musculoskeletal disease · 2025Review
- Cardiac disease in systemic sclerosis: a narrative review.Archives of medical sciences. Atherosclerotic diseases · 2025Article
- Current understanding and management of cardiovascular involvement in rheumatic immune-mediated inflammatory diseases.Nature reviews. Rheumatology · 2024Review
- Progranulin, sICAM-1, and sVCAM-1 May Predict an Increased Risk for Ventricular Arrhythmias in Patients with Systemic Sclerosis.International journal of molecular sciences · 2024Article
- The role of comprehensive stress cardiac MRI in autoimmune rheumatic disease: A review.International journal of cardiology. Heart & vasculature · 2024Review
- The emerging role of cardiovascular magnetic resonance in the evaluation of cardiac involvement in systemic sclerosis.Rheumatology and immunology research · 2024Article
- Cardiac magnetic resonance imaging in systemic sclerosis: Heart involvement in high-resolution.Rheumatology and immunology research · 2024Article
- Digital Ulcers and Ventricular Arrhythmias as Red Flags to Predict Replacement Myocardial Fibrosis in Systemic Sclerosis.Journal of clinical medicine · 2023Article
- Cardiovascular Magnetic Resonance for the Evaluation of Arrhythmogenic Substrates in Patients with Systemic Autoimmunity: An Update.Reviews in cardiovascular medicine · 2023Review
- Cardiac Magnetic Resonance-Detected Acute Myocardial Edema as Predictor of Favourable Prognosis: A Comprehensive Review.Journal of cardiovascular development and disease · 2023Review
- Heart Involvement in Systemic Sclerosis: the Role of Magnetic Resonance Imaging.Clinical reviews in allergy & immunology · 2023Review
- Distinct cardiovascular phenotypes are associated with prognosis in systemic sclerosis: a cardiovascular magnetic resonance study.European heart journal. Cardiovascular Imaging · 2023Observational
- Concomitant symptomatic cardiac sarcoidosis and systemic sclerosis with cardiac involvement: a case report.American journal of cardiovascular disease · 2023Article
- Myocardial fibrosis and arrhythmic burden in systemic sclerosis.Rheumatology (Oxford, England) · 2022Article
Corrections and comments
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Authors and funding
21 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesCardiac rhythm disturbances constitute the most frequent cardiovascular cause of death in SSc. However, electrocardiographic findings are not a part of risk stratification in SSc. We aimed to translate 24 h Holter findings into a tangible risk prediction score using cardiovascular magnetic resonance.
methodsThe Scleroderma Arrhythmia Clinical Utility Study (SAnCtUS) was a prospective multicentre study including 150 consecutive SSc patients from eight European centres, assessed with 24 h Holter and cardiovascular magnetic resonance, including ventricular function, oedema (T2 ratio) and late gadolinium enhancement (%LGE). Laboratory/clinical parameters were included in multivariable corrections. A combined endpoint of sustained ventricular tachycardia requiring hospitalization and sudden cardiac death at a median (interquartile range) follow-up of 1 (1.0-1.4) year was generated.
resultsOnly T2 ratio and %LGE were significant predictors of ventricular rhythm disturbances, but not of supraventricular rhythm disturbances, after multivariable correction and adjustment for multiple comparisons. Using decision-tree analysis, we created the SAnCtUS score, a four-category scoring system based on T2 ratio and %LGE, for identifying SSc patients at high risk of experiencing ventricular rhythm disturbance at baseline. Increasing SAnCtUS scores were associated with a greater disease and arrhythmic burden. All cases of non-sustained ventricular tachycardia (n = 7) occurred in patients with the highest SAnCtUS score (=4). Having a score of 4 conveyed a higher risk of reaching the combined endpoint in multivariable Cox regression compared with scores 1/2/3 [hazard ratio (95% CI): 3.86 (1.14, 13.04), P = 0.029] independently of left ventricular ejection fraction and baseline ventricular tachycardia occurrence.
conclusionT2 ratio and %LGE had the greatest utility as independent predictors of rhythm disturbances in SSc patients.
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