Heart failure & cardiomyopathies
Distinct cardiovascular phenotypes are associated with prognosis in systemic sclerosis: a cardiovascular magnetic resonance study
Authors' conclusion
We identified five CMR-defined cardiac SSc phenotypes that did not co-segregate with clinical data and had distinct outcomes, offering opportunities for a more precision-medicine based management approach.
Study context
- Population
- Systemic sclerosis (SSc) patients undergoing clinically indicated cardiovascular magnetic resonance (CMR) with native T1 and T2 mapping, 2016–2019
- Participants
- 260 patients
- Exposure
- CMR-defined cardiac phenotypes in SSc
- Outcome
- All-cause mortality
- Follow-up
- Median 3.4 years
Methodological detailssingle-centre, observational, agglomerative hierarchical clustering
- Single-centre
- Observational
- Agglomerative hierarchical clustering
Main finding
As reported in the abstract
All-cause mortality by phenotype
Hazard ratio
8.9
P < 0.001
Right ventricular failure (RVF)
Hazard ratio
5.2
P = 0.006
BVF
Hazard ratio
4.9
P = 0.002
Normal function with large cavity (NF-LC)
- Deaths during follow-up
- 63 (24%)
- Normal function with small cavity (NF-SC) and normal function with average cavity (NF-AC) had more favourable prognoses than the other three groups
- P ≤ 0.036
- No differences in prognoses between RVF, BVF and NF-LC
- P > 0.14
- NF-LC remained predictive of mortality after adjusting for right ventricular ejection fraction (RVEF), native T1 and PH diagnosis
- P = 0.0046
Observational data: associations, not effects.
Further findings
Independent CMR predictors of all-cause mortality (adjusted for age and PH)
- Native T1
- P < 0.001
- RVEF
- P = 0.0032
Co-segregation with clinical or antibody classifications
- Phenotypes did not co-segregate with clinical or antibody classifications
Original publication
Distinct cardiovascular phenotypes are associated with prognosis in systemic sclerosis: a cardiovascular magnetic resonance study. Eur Heart J Cardiovasc Imaging. Published 1 July 2022. doi:10.
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