Heart failure & cardiomyopathies
Role of exercise stress echocardiography in systemic sclerosis: pathophysiological and prognostic significance of the systemic sclerosis with a heart failure and preserved ejection fraction phenotype
Main finding · Composite of all-cause mortality, HF hospitalization, unplanned hospital visits requiring intravenous diuretics, or oral diuretic intensificationResult — go to the resultHazard ratio 5.29 CI 2.06–13.5Authors' conclusion
In addition to pulmonary haemodynamics, exercise stress echocardiography may be useful to identify the HFpEF phenotype that has different pathophysiology and clinical outcomes in patients with SSc.
Study context
- Population
- Patients with systemic sclerosis (SSc)patients with SSc, exercise right heart catheterization in 25
- Participants
- 140 patients
- Comparison
- SSc-HFpEF vs SSc-non-HFpEF
- SSc-HFpEFn = 35
- Outcome
- Composite of:
- All-cause mortality
- HF hospitalization
- Unplanned hospital visits requiring intravenous diuretics
- Oral diuretic intensification
Main finding
As reported in the abstract
Hazard ratio
5.29
CI 2.06–13.5
P = 0.0005
SSc-HFpEFvs SSc-non-HFpEF
hazard ratio 5.29 (CI 2.06–13.5); P = 0.0005
Further findings
Heart failure with preserved ejection fraction (HFpEF) prevalence
- Patients meeting HFpEF criteria
- Thirty-five patients met the HFpEF criteria (prevalence 25%)
Characteristics of SSc-HFpEF vs SSc-non-HFpEF
- SSc-HFpEF older, higher prevalence of coronary artery disease, more severe left ventricular (LV) diastolic dysfunction (by definition), depressed right ventricular systolic function, reduced exercise capacity (lower peak oxygen consumption), poorer ventilatory efficiency
Pulmonary capillary wedge pressure during peak exercise (exercise right heart catheterization)
- Confirmed elevated pulmonary capillary wedge pressure in patients with SSc-HFpEF
- Performed in 25 patients
Original publication
Role of exercise stress echocardiography in systemic sclerosis: pathophysiological and prognostic significance of the systemic sclerosis with a heart failure and preserved ejection fraction phenotype. Eur Heart J Cardiovasc Imaging. Published 21 January 2025. doi:10.
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