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dc.contributor.authorDumitru, Raluca B
dc.contributor.authorBissell, Lesley-Anne
dc.contributor.authorErhayiem, Bara
dc.contributor.authorKidambi, Ananth
dc.contributor.authorDumitru, Ana-Maria H
dc.contributor.authorFent, Graham
dc.contributor.authorAbignano, Giuseppina
dc.contributor.authorDonica, Helena
dc.contributor.authorBurska, Agata
dc.contributor.authorGreenwood, John P
dc.contributor.authorBiglands, John
dc.contributor.authorSchlosshan, Dominik
dc.contributor.authorDel Galdo, Francesco
dc.contributor.authorPlein, Sven
dc.contributor.authorBuch, Maya H; orcid: 0000-0002-8962-5642; email: maya.buch@manchester.ac.uk
dc.date.accessioned2021-11-02T01:28:32Z
dc.date.available2021-11-02T01:28:32Z
dc.date.issued2021-10
dc.date.submitted2021-04-06
dc.identifierpubmed: 34663635
dc.identifierpii: rmdopen-2021-001689
dc.identifierdoi: 10.1136/rmdopen-2021-001689
dc.identifier.citationRMD open, volume 7, issue 3
dc.identifier.urihttp://hdl.handle.net/10034/626257
dc.descriptionFrom PubMed via Jisc Publications Router
dc.descriptionHistory: received 2021-04-06, accepted 2021-09-06
dc.descriptionPublication status: ppublish
dc.description.abstractTo explore the prognostic value of subclinical cardiovascular (CV) imaging measures and serum cardiac biomarkers in systemic sclerosis (SSc) for the development of CV outcomes of primary heart involvement (pHI). Patients with SSc with no clinical SSc-pHI and no history of heart disease underwent cardiovascular magnetic resonance (CMR) imaging, and measurement of serum high-sensitivity-troponin I (hs-TnI) and N-terminal-pro-brain natriuretic peptide (NT-proBNP). Follow-up clinical and CV outcome data were recorded. CV outcomes were defined as myocarditis, arrhythmia and/or echocardiographic functional impairment including systolic dysfunction and/or diastolic dysfunction. Seventy-four patients with a median (IQR) age of 57 (49, 63) years, 32% diffuse cutaneous SSc, 39% interstitial lung disease, 30% Scl70+ were followed up for median (IQR) 22 (15, 54) months. Ten patients developed CV outcomes, comprising one patient with myocarditis and systolic dysfunction and nine arrhythmias: three non-sustained ventricular tachycardia and six supraventricular arrhythmias. The probability of CV outcomes was considerably higher in those with NT-proBNP >125 pg/mL versus normal NT-proBNP (X =4.47, p=0.035). Trend for poorer time-to-event was noted in those with higher extracellular volume (ECV; indicating diffuse fibrosis) and hs-TnI levels versus those with normal values (X =2.659, p=0.103; X =2.530, p=0.112, respectively). In a predictive model, NT-proBNP >125 pg/mL associated with CV outcomes (OR=5.335, p=0.040), with a trend observed for ECV >29% (OR=4.347, p=0.073). These data indicate standard serum cardiac biomarkers (notably NT-proBNP) and CMR indices of myocardial fibrosis associate with adverse CV outcomes in SSc. This forms the basis to develop a prognostic model in larger, longitudinal studies. [Abstract copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.]
dc.languageeng
dc.sourceeissn: 2056-5933
dc.subjectsystemic
dc.subjectFibrosis
dc.subjectMagnetic Resonance Imaging
dc.subjectMiddle Aged
dc.subjectProspective Studies
dc.subjectscleroderma
dc.subjectBiomarkers
dc.subjectcardiovascular diseases
dc.subjectScleroderma, Systemic - complications - diagnostic imaging
dc.subjectHumans
dc.titleCardiovascular outcomes in systemic sclerosis with abnormal cardiovascular MRI and serum cardiac biomarkers.
dc.typearticle
dc.date.updated2021-11-02T01:28:31Z
dc.date.accepted2021-09-06


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