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Cardiac Involvement in Systemic Sclerosis

Diagnostic Tools and Evaluation Methods

Smolenska, Zaneta, MD, PhD1; Barraclough, Rufus, MD2; Dorniak, Karolina, MD, PhD3; Szarmach, Arkadiusz, MD, PhD4; Zdrojewski, Zbigniew, MD, PhD1

doi: 10.1097/CRD.0000000000000221
Review Article: PDF Only

The heart is one of the major organs commonly involved in systemic sclerosis. Myocardial fibrosis has been identified in a high percentage of these patients. Most systemic sclerosis patients with cardiac involvement are subclinical, especially early on in the course of their disease. To accurately identify cardiac involvement and improve diagnosis and treatment, imaging techniques should be implemented on a regular basis following diagnosis. In this review, we discuss the up-to-date pathophysiologic basis of cardiac involvement, the cardiac manifestations, and the diagnostic methods which have been published in the literature.

Recent studies have shown that tissue Doppler imaging is a promising evaluation technique in the bedside detection of cardiac involvement. Cardiovascular magnetic resonance is an operator-independent method used for detecting systemic sclerosis cardiac involvement. It is an especially useful tool in the early stages of the disease when patients may be asymptomatic. At present, it is the most promising imaging technique for the diagnosis, follow-up and response to therapy in clinical practice.

1 Department of Internal Medicine, Connective Tissue Diseases and Geriatrics

2 Department of Hypertension and Diabetology

3 Department of Noninvasive Cardiac Diagnostics

4Department of Radiology, Medical University of Gdansk, Poland

Conflict of interest section: none declared

Corresponding author: Zaneta Smolenska MD, PhD, Department of Internal Diseases, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Dębinki 7, 80-952, Gdansk, Poland, phone+48 58 349 28 32, e-mail:

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