Background Cardiac involvement is a major cause of death in SSc, while early detection remains a challenge. Objectives The purpose of this study was to investigate the prevalence and clinical implications of cardiac impairment in SSc. Methods Ninety-five consecutive SSc patients [55.6 (13.8) years old, 5.3 (8.1) years from diagnosis] were included in the study. Patients with heart diseases onset prior to SSc were excluded. All patients underwent two-dimensional speckle-tracking echocardiology (2D-STE) with measuring left and right ventricular global longitudinal strain (GLS/RGLS). Clinical manifestation, laboratory evaluation (CRP, cTnI, antibodies, etc.) and ECG were collected at the same time. Comparisons between the SSc subgroups (lcSSc and dcSSc) were performed using Student’s t-test, Mann–Whitney U or Fisher’s exact test. Binary logistic regression was applied to determine the independent effects of variables in cardiac impairment. Results Early left and right ventricular impairment measured by GLS and RGLS were detected in 22.1% and 24.2% of the SSc patients, respectively. In comparison, only 2.1% showed reduced left ventricular ejection fraction (LVEF). Impaired GLS was mainly observed in the basal and medial segments of anterior, lateral and posterior left ventricle walls, and more profound in dcSSc. Elevated CRP (OR 3.561 95% CI: 1.071, 11.839, P <0.05) was associated with reduced GLS/RGLS. The adoption of GLS/RGLS enhanced the efficacy of routine screening for cardiac impairment that 52.6% of patients showed potential cardiac impairment. Conclusions Cardiac impairment is a common manifestation in SSc. Increasing awareness of early cardiac impairment is warranted with elevated CRP and dcSSc.

中文翻译：

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二维散斑追踪超声心动图对系统性硬化症患者心脏损害的临床评估

背景 心脏受累是 SSc 死亡的主要原因，而早期发现仍然是一个挑战。目的 本研究的目的是调查 SSc 中心脏损害的患病率和临床意义。方法 95 名连续 SSc 患者 [55.6 (13.8) 岁，诊断后 5.3 (8.1) 年] 被纳入研究。在 SSc 之前发病的心脏病患者被排除在外。所有患者均接受二维散斑追踪超声心动图 (2D-STE) 并测量左右心室整体纵向应变 (GLS/RGLS)。同时采集临床表现、实验室评价（CRP、cTnI、抗体等）和心电图。SSc 亚组（lcSSc 和 dcSSc）之间的比较使用学生 t 检验、Mann-Whitney U 或 Fisher 精确检验进行。应用二元逻辑回归来确定变量对心脏损伤的独立影响。结果 GLS 和 RGLS 测量的早期左心室和右心室受损分别在 22.1% 和 24.2% 的 SSc 患者中检出。相比之下，只有 2.1% 的人左心室射血分数 (LVEF) 降低。GLS 受损主要见于左心室前壁、外壁和后壁的基底段和内侧段，在 dcSSc 中更为明显。CRP 升高 (OR 3.561 95% CI: 1.071, 11.839, P <0.05) 与 GLS/RGLS 降低有关。GLS/RGLS 的采用提高了心脏损伤常规筛查的功效，52.6% 的患者显示出潜在的心脏损伤。结论 心功能不全是SSc的常见表现。