ArticleArthritis & rheumatology (Hoboken, N.J.)2022
Diastolic Dysfunction in Systemic Sclerosis: Risk Factors and Impact on Mortality.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Myocardial Performance Index to assess cardiac function in autoimmune connective tissue disease: a systematic review and meta-analysis.Lupus science & medicine · 2024Pooled it
- Noncoding RNA TY1 reverses fibrosis in systemic sclerosis by attenuating the cGAS/STING pathway.JCI insight · 2026Article
- Echocardiographic characterization of combined postcapillary and precapillary pulmonary hypertension in systemic sclerosis with preserved ejection fraction.Echo research and practice · 2026Article
- Association between myocardial involvement and subclinical left ventricular dysfunction in patients with systemic sclerosis: a cardiac magnetic resonance study.Quantitative imaging in medicine and surgery · 2026Article
- Systemic sclerosis and cardiovascular disease: an integrative perspective on immune-vascular mechanisms and emerging risk stratification strategies.Rheumatology international · 2026Review
- Cardiac involvement in systemic sclerosis: mechanisms, manifestations and management.Rheumatology (Oxford, England) · 2026Review
- Risk stratifying systemic sclerosis-related pulmonary hypertension by left atrial strain.Rheumatology (Oxford, England) · 2026Article
- Are the clinical phenotypes of systemic sclerosis determinant for osteoporosis and fragility fractures?BMC rheumatology · 2025Article
- Myocardial Disease in Systemic Sclerosis: Recent Updates and Clinical Implications.Current cardiology reports · 2025Review
- Current understanding and management of cardiovascular involvement in rheumatic immune-mediated inflammatory diseases.Nature reviews. Rheumatology · 2024Review
- The Scleroderma Tango: Unraveling the Delicate Dance of Diastolic Dysfunction and Interstitial Lung Disease.The Journal of rheumatology · 2024Article
- Novel Imaging Approaches to Cardiac Manifestations of Systemic Inflammatory Diseases: JACC Scientific Statement.Journal of the American College of Cardiology · 2023Review
- Serum markers in systemic sclerosis with cardiac involvement.Clinical rheumatology · 2023Review
- Impaired left-ventricular global longitudinal strain by feature-tracking cardiac MRI predicts mortality in systemic sclerosis.Rheumatology international · 2023Article
- Association between systemic sclerosis and left ventricle dysfunction: Findings from observational studies.Heliyon · 2023Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo determine the independent risk factors for diastolic dysfunction (DD) in patients with systemic sclerosis (SSc) and to evaluate the impact of DD on mortality.
methodsSSc patients enrolled in the Johns Hopkins Scleroderma Center Cohort between November 1, 2006 and November 1, 2017 with ≥1 analyzable 2-dimensional (2-D) echocardiogram in our system were included (n = 806). DD risk factors and SSc disease characteristics were prospectively obtained, and the presence or absence of DD was determined using the most recent 2-D echocardiogram. Logistic regression models examined associations between clinical risk factors and DD, and Cox proportional hazards models were used to assess survival.
resultsDD was present in 18.6% of participants. The majority of participants were female (84%) with a median age of 58.4 years (interquartile range 48.8-68.1). Older age (odds ratio [OR] 1.12 [95% confidence interval (95% CI) 1.09-1.15], P < 0.001), coronary artery disease (OR 3.69 [95% CI 1.52-8.97], P = 0.004), obesity (OR 4.74 [95% CI 2.57-8.74], P < 0.001), longer SSc disease duration (OR 1.04 [95% CI 1.01-1.06], P = 0.004), diffusing capacity for carbon monoxide ≤60% of predicted (OR 2.41 [95% CI 1.40-4.16], P = 0.002), and history of scleroderma renal crisis (OR 3.18 [95% CI 1.12-9.07], P = 0.031) were all independently associated with an increased risk of DD. Anti-Scl-70 positivity (OR 0.49 [95% CI 0.26-0.93], P = 0.03) and severe gastrointestinal disease (OR 0.48 [95% CI 0.30-0.79], P = 0.004) were associated with a reduced risk of DD. The presence of DD was independently associated with an increase in the risk of mortality (hazard ratio 1.69 [95% CI 1.07-2.68], P = 0.027).
conclusionDD is independently associated with an increased risk of mortality in patients with SSc. Potentially modifiable risk factors, including coronary artery disease and obesity, should be addressed in patients with SSc to reduce mortality risk.
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