Early Detection of Cardiac Involvement in Systemic Sclerosis

Cardiac involvement in systemic sclerosis (SSc) is
frequent and significantly affects the prognosis.
Myocardial fibrosis is the pathological hallmark
and has been reported in >50% of necropsies (1).
Given the low sensitivity of transthoracic
echocardiography (TTE) in detecting myocardial
fibrosis, late gadolinium enhancement (LGE)
cardiovascular magnetic resonance (CMR) is
considered the noninvasive gold standard for
imaging macroscopic myocardial fibrosis. Our aim
was to evaluate the added value of LGE CMR to TTE
in a large group of patients with SSc.
A total of 201 patients with SSc (90.5% women; 51
14 years of age) without known SSc-related cardiac
involvement were enrolled. All patients signed
informed consent. All patients underwent comprehensive TTE with tissue Doppler imaging on the same
day as 1.5-T LGE CMR with T1- and T2-weighted
sequences. A standard 24-h Holter electrocardiogram (ECG) was recorded when clinically indicated;
ventricular arrhythmias were defined by Lown
classification grade $2.