Left ventricular diastolic dysfunction in systemic sclerosis: Clinical, immunological and survival differences in the Spanish RESCLE registry.

Cristina González-Echávarri, Carmen Pilar Simeón Aznar, Vicent Fonollosa Pla, Carles Tolosa Vilella, Sabela Sánchez Trigo, Ana Belén Madroñero Vuelta, Isabel Perales Fraile, Antonio-J Chamorro, Mayka Freire, María Teresa Herranz Marín, Luis Trapiella Martínez, José Antonio Todolí Parra, José Antonio Vargas Hitos, Norberto Ortego-Centeno, Andrés González García, Luis Sáez Comet, Dolores Colunga Argüelles, Eduardo Callejas Moraga, Begoña Marí-Alfonso, Xavier Pla Salas, Ignasi Rodríguez Pintó, Adela Marín Ballvé, Ana Argibay, Manuel Rubio Rivas, Alfredo Guillén Del Castillo, Luis Manzano, Martin Fabregate

Journal: Seminars in arthritis and rheumatism 2022;55():152033

PMID: 35691226

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVES

Left ventricular diastolic dysfunction (LVDD) remains poorly studied in Systemic Sclerosis (SSc). To determine the prevalence and to define factors associated with LVDD and survival in a large cohort of patients with SSc.

METHODS

An observational study was conducted with data from the multicentre Spanish Scleroderma Registry (RESCLE) to identify factors associated with LVDD and estimate survival.

RESULTS

Out of 1517 patients, 319 (21.0%) had LVDD. The subset of sine scleroderma SSc was associated to LVDD (14.7% vs. 10.6%, p =0.048), whilst diffuse cutaneous SSc was more prevalent in non-LVDD (16.0 % vs. 21.2%, p =0.041). Multivariable analysis identified that LVDD was associated with older age at diagnosis of SSc (OR 1.05; 95% CI 1.04 to 1.06), longer time from diagnosis (OR 1.04; 95% CI 1.03 to 1.06), presence of telangiectasia (OR 1.42; 95% CI 1.08 to 1.88), treatment with calcium channel blockers (CCB) (OR 1.51; 95% CI 1.16 to 1.96), and inversely related to angiotensin-converting-enzyme inhibitors (ACEi) use (OR 0.59; 95% CI 0.44 to 0.80). SSc patients with LVDD had increased mortality (23.8 vs. 17.4%, p =0.010) and shortened survival from the first SSc symptom (p =0.040), even though it was not found to be an independent risk factor for death.

CONCLUSIONS

LVDD is relatively common in SSc patients, and it is associated with worst prognosis, older age, longer time from diagnosis of SSc, presence of telangiectasia and vasodilator treatment.

Address: Systemic Autoimmune Diseases Unit, Department of Internal Medicine. Hospital Universitario Ramón y Cajal, Universidad de Alcalá (UAH), IRYCIS, Carretera Colmenar Km 9.1, Madrid 28034, Spain; Faculty of Medicine and Health Sciences, Universidad de Alcalá (UAH). Alcalá de Henares, Madrid, Spain. Electronic address: [email protected].; Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.; Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Faculty of Medicine and Health Sciences, Universidad de Alcalá (UAH). Alcalá de Henares, Madrid, Spain.; Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain.; Unit of Autoimmune Diseases, Department of Internal Medicine, IDIBELL. L'Hospitalet de Llobregat, Hospital Universitario de Bellvitge, Barcelona, Spain.; Department of Internal Medicine Complejo, Unit of Systemic Autoimmune Diseases and Thrombosis, Hospitalario Universitario de Vigo. Vigo, Pontevedra, Spain.; Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain.; Department of Internal Medicine, Hospital Universitario Mútua Terrassa, Terrassa, Barcelona, Spain.; Department of Internal Medicine, Unit of Systemic Autoimmune Diseases, Consorci Hospitalari de Vic. Vic, Barcelona, Spain.; Department of Internal Medicine, Parc Taulí, Hospital Universitario. Sabadell, Barcelona, Spain.; Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.; Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain.; Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain.; Department of Internal Medicine, Inst Invest Biosanitaria Ibs Granada, Unit of Systemic Autoimmune Diseases. Department of Medicine, Facultad de Medicina, Hospital Universitario San Cecilio, Granada, Spain.; Department of Internal Medicine, Hospital Universitario Virgen de las Nieves, Granada, Spain.; Department of Internal Medicine, Hospital Universitario y Politécnico La Fe, Valencia, Spain.; Department of Internal Medicine, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain.; Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, Spain.; Department of Internal Medicine, Hospital Clínico Universitario de Salamanca-IBSAL, Salamanca, Spain.; Department of Internal Medicine, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.; Department of Internal Medicine, Hospital General San Jorge, Huesca, Spain.; Department of Internal Medicine Complejo, Hospitalario Universitario de Ferrol, Ferrol, A Coruña, Spain.

DOI: 10.1016/j.semarthrit.2022.152033

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MeSH Terms: Cohort Studies, Humans, Registries, Scleroderma, Diffuse, Scleroderma, Systemic, Telangiectasis, Ventricular Dysfunction, Left