Article Text
Abstract
Objectives: To measure the prevalence of, and factors associated with, left ventricular (LV) dysfunction in systemic sclerosis (SSc).
Methods: The EUSTAR database was first searched. A case-control study of a patient subset was then performed to further identify independent factors associated with LV dysfunction by simple and multiple regression.
Results: Of 7073 patients, 383 (5.4%) had an LV ejection fraction (EF) of <55%. By multiple regression analysis, age, sex, diffuse cutaneous disease, disease duration, digital ulcerations, renal and muscle involvement, disease activity score, pulmonary fibrosis and pulmonary arterial hypertension were associated with LV dysfunction. In the second phase, 129 patients with SSc with LVEF <55% were compared with 256 patients with SSc with normal LVEF. Male sex (OR 3.48; 95% CI 1.74 to 6.98), age (OR 1.03; 95% CI 1.01 to 1.06), digital ulcerations (OR 1.91; 95% CI 1.05 to 3.50), myositis (OR 2.88; 95% CI 1.15 to 7.19) and use of calcium channel blockers (OR 0.41; 95% CI 0.22 to 0.74) were independent factors associated with LV dysfunction.
Conclusion: The prevalence of LV dysfunction in SSc is 5.4%. Age, male gender, digital ulcerations, myositis and lung involvement are independently associated with an increased prevalence of LV dysfunction. Conversely, the use of calcium channel blockers may be protective.
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Footnotes
▸ Additional details of the methods and statistical analysis used and EUSTAR co-authors are published online only at http://ard.bmj.com/content/vol69/issue1
EUSTAR co-authors are listed in file 2 in the online supplement.
For numbered affiliations see end of article
Funding EUSTAR is supported by a research grant from EULAR and is under the auspices of the Standing Committee for International Studies Including Clinical Trials (ESCCA).
Competing interests None.
EUSTAR co-authors are listed in file 2 in the online supplement.
Provenance and Peer review Not commissioned; externally peer reviewed.