Osgueritchian Ryan, Mombeini Hoda, Jani Vivek P, Hsu Steven, Hummers Laura K, Wigley Fredrick M, Mathai Stephen C, Shah Ami A, Mukherjee Monica
Johns Hopkins University Division of Cardiology, Baltimore, MD, USA.
Johns Hopkins University Division of Rheumatology, Baltimore, MD, USA.
Curr Cardiol Rep. 2025 Jan 4;27(1):3. doi: 10.1007/s11886-024-02164-w.
The present review aims to address systemic sclerosis (SSc)-associated myocardial disease, a significant cause of morbidity and mortality, by examining the mechanisms of inflammation, microvascular dysfunction, and fibrosis that drive cardiac involvement. The objective is to elucidate critical risk factors and explore advanced diagnostic tools for early detection, enhancing patient outcomes by identifying those at highest risk.
Recent studies underscore the importance of specific autoantibody profiles, disease duration, and cardiovascular comorbidities as key risk factors for severe cardiac manifestations in SSc. Additionally, advanced imaging techniques and biomarker analyses have emerged as pivotal tools for early identification and risk stratification. These innovations enable clinicians to detect subclinical myocardial involvement, potentially averting progression to symptomatic disease. SSc-associated myocardial disease remains challenging to predict, yet novel imaging modalities and biomarker-guided strategies offer a promising pathway for early diagnosis and targeted intervention. Integrating these approaches may enable more effective early detection and screening strategies as well as mitigation of disease progression, ultimately enhancing clinical outcomes for patients with SSc at-risk for adverse clinical outcomes.
本综述旨在通过研究驱动心脏受累的炎症、微血管功能障碍和纤维化机制，探讨系统性硬化症（SSc）相关心肌病，这是发病和死亡的一个重要原因。目的是阐明关键危险因素，并探索用于早期检测的先进诊断工具，通过识别高危患者来改善患者预后。
最近的研究强调了特定自身抗体谱、疾病持续时间和心血管合并症作为SSc严重心脏表现关键危险因素的重要性。此外，先进的成像技术和生物标志物分析已成为早期识别和风险分层的关键工具。这些创新使临床医生能够检测亚临床心肌受累，有可能避免进展为有症状的疾病。SSc相关心肌病的预测仍然具有挑战性，但新型成像模式和生物标志物指导的策略为早期诊断和靶向干预提供了一条有前景的途径。整合这些方法可能会实现更有效的早期检测和筛查策略以及减轻疾病进展，最终改善有不良临床结局风险的SSc患者的临床预后。
