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Ann Rheum Dis doi:10.1136/ard.2008.103382

Prevalence and factors associated with left ventricular dysfunction in the EULAR Scleroderma Trial and Research group (EUSTAR) database of systemic sclerosis patients

  1. Y Allanore (yannick.allanore{at}cch.aphp.fr)
  1. Université Paris Descartes; APHP; Hôpital Cochin, Service de Rhumatologie A, Paris, France
    1. C Meune
    1. Université Paris Descartes ;APHP ; Hôpital Cochin, Service de Cardiologie, Paris, France
      1. M C Vonk
      1. Reumatology, Radboud University Nijmegen Medical Centre, huispost 470, PB 91016500 HB Nijmegen, Netherlands
        1. P Airo
        1. Servizio di Reumatologia ed Immunologia Clinica, Spedali Civili, Brescia, Italy
          1. E Hachulla
          1. Service de Médecine Interne, Lille, France
            1. P Caramaschi
            1. Dipartimento di Medicina Clinica e Sperimentale, Università di Verona, Policlinico G.B. Rossi, Italy
              1. G Riemekasten
              1. Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie der Charité Universität, Germany
                1. F Cozzi
                1. Rheumatology Unit, University of Padova, Via Giustiniani 2-35128 Padova, Italy
                  1. L Beretta
                  1. IRCCS Fondazione Policlinico-Mangiagalli-Regina Elena and University of Milan, Milan, Italy
                    1. C T Derk
                    1. Division of Rheumatology, Thomas Jefferson University, 613 Curtis Bldg, Philadelphia, United States
                      1. A Komósi
                      1. Heart Institute, Faculty of Medicine, University of Pécs, 13. Ifjuság Str., H-7623 Pécs, Hungary
                        1. D Farge
                        1. Service de médecine interne et pathologie vasculaire, hôpital Saint-Louis, INSERM U697, Paris, France
                          1. A Balbir
                          1. B. Shine Department of Rheumatology, Rambam Health Care Campus, Haifa, Israel
                            1. V Riccieri
                            1. Cattedra di Reumatologia, Department of Clinical and Medical Therapy, University of Rome La Sapienza, Italy
                              1. O Distler
                              1. University Hospital Zurich, Zurich, Switzerland
                                1. A Chialà
                                1. DIMIMP, Sezione di Reumatologia, Università degli Studi di Bari, Italy
                                  1. N del papa
                                  1. Department of Rheumatology, G. Pini Hospital, Milano, Italy
                                    1. K Simic Pasalic
                                    1. Institute Rheumatology, Belgrade, Serbia and Montenegro
                                      1. M Ghio
                                      1. Department of Internal Medicine, University and San Martino Hospital of Genoa, Genoa, Italy
                                        1. B Stamenkovic
                                        1. Institute for Prevention and Treatment of Rheumatic and Cardiovascular Disease Ni ka Banja, Serbia and Montenegro
                                          1. S Rednic
                                          1. Department of Rheumatology, Romania
                                            1. N Host
                                            1. Department of Cardiology Y, Bispebjerg University Hospital, DK-2400 Copenhagen, Denmark
                                              1. R Pellerito
                                              1. Ospedale Mauriziano Umberto I, Largo Turati 62, 10128 Torino, Italy
                                                1. E Zegers
                                                1. Cardiology, Radboud University Nijmegen Medical Centre, huispost 470, PB 91016500 HB Nijmegen, Netherlands
                                                  1. A Kahan
                                                  1. Université Paris Descartes; APHP; Hôpital Cochin, Service de Rhumatologie A, Paris, France
                                                    1. U A Walker
                                                    1. Medizinische Universitätsklinik Freiburg, Switzerland
                                                      1. M Matucci-Cerinic
                                                      1. Department of BioMedicine, Division of Rheumatology AOUC, University of Florence, Italy
                                                        • Published Online First 10 March 2009

                                                        Abstract

                                                        Study objectives and methods: To measure the prevalence of, and factors associated with, left ventricular (LV) dysfunction in SSc, we first queried the EUSTAR database. In a second phase, we performed a case-control study of a patient subset, to further identify independent factors associated with LV dysfunction by simple and multiple regression.

                                                        Results: Among 7,073 patients, 383 (5.4%) had a LV ejection fraction (EF) <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 (PAH) were associated with LV dysfunction. In a second phase, 129 SSc patients with LVEF <55% were compared with 256 SSc patients with normal LVEF. Male sex (OR 3.48; 95% CI1.74-6.98), age (OR 1.03; 95% CI 1.01-1.06), digital ulcerations (OR 1.91; 95% CI 1.05-3.50), myositis (OR 2.88; 95% CI 1.15-7.19), and calcium channel blockers (CCB) use (OR 0.41; 95% CI 0.22-0.74) 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 increased prevalence of LV dysfunction. Conversely, CCB use may appear as protective.

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