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Article Dans Une Revue Rheumatology Année : 2023

Heart and systemic sclerosis—findings from a national cohort study

Luc Mouthon
Benjamin Chaigne
Grégory Pugnet
Arnaud Hot
  • Fonction : Auteur
Christian Agard
Yannick Allanore
  • Fonction : Auteur
Anne-Laure Fauchais
  • Fonction : Auteur
Robin Dhote
  • Fonction : Auteur
Thomas Papo
  • Fonction : Auteur
Emmanuel Chatelus
Bernard Bonnotte
  • Fonction : Auteur
Jean-Emmanuel Khan
  • Fonction : Auteur
Elisabeth Diot
  • Fonction : Auteur
Boris Bienvenu
  • Fonction : Auteur
Nadine Magy-Bertrand
  • Fonction : Auteur
Viviane Queyrel
  • Fonction : Auteur
Alain Le Quellec
  • Fonction : Auteur
Pierre Kieffer
  • Fonction : Auteur
Zahir Amoura
  • Fonction : Auteur
Jean-Robert Harlé
  • Fonction : Auteur
Jean-Baptiste Gaultier
  • Fonction : Auteur
Marie-Hélène Balquet
  • Fonction : Auteur
Denis Wahl
  • Fonction : Auteur
Olivier Lidove
  • Fonction : Auteur
Olivier Fain
Sebastien Rivière
  • Fonction : Auteur

Résumé

Abstract Objectives Heart involvement is one of the leading causes of death in SSc. The prevalence of SSc-related cardiac involvement is poorly known. Our objective was to investigate the prevalence and prognosis burden of different heart diseases in a nationwide cohort of patients with SSc. Methods We used data from a multicentric prospective study using the French SSc national database. Focusing on SSc-related cardiac involvement, we aimed to determine its incidence and risk factors. Results Of the 3528 patients with SSc, 312 (10.9%) had SSc-related cardiac involvement at baseline. They tended to have a diffuse SSc subtype more frequently and to have more severe clinical features, and presented more cardiovascular risk factors. From the 1646 patients available for follow-up analysis, SSc-related cardiac involvement was associated with an increased risk of death. There was no significant difference in overall survival between SSc-related cardiac involvement, ischaemic heart disease or pulmonary arterial hypertension. Regarding survival analysis, 98 patients developed SSc-related cardiac involvement at 5 years (5-year event rate 11.15%). Regarding reduced left ventricular ejection fraction <50% and left ventricular diastolic dysfunction, the 5-year event rate was 2.49% and 5.84%, respectively. Pericarditis cumulative incidence at 5 years was 3%. Diffuse SSc subtype was a risk factor for SSc-related cardiac involvement and pericarditis. Female sex was associated with less left ventricular diastolic dysfunction incidence. Conclusions Our results describe the incidence and prognostic burden of SSc-related cardiac involvement at a large scale, with gender and diffuse SSc subtype as risk factors. Further analyses should assess the potential impact of treatment on these various cardiac outcomes.
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Dates et versions

hal-04313392 , version 1 (29-11-2023)

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Alexis Guédon, Fabrice Carrat, Luc Mouthon, David Launay, Benjamin Chaigne, et al.. Heart and systemic sclerosis—findings from a national cohort study. Rheumatology, 2023, ⟨10.1093/rheumatology/kead599⟩. ⟨hal-04313392⟩
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