Koletsos Nikolaos, Kaltsonoudis Evripidis, Pelechas Eleftherios, Drosos Alexandros A, Voulgari Paraskevi V
Department of Rheumatology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Stavrou Niarchou Avenue, 45500, Ioannina, Greece.
Rheumatol Int. 2025 Jul 14;45(8):169. doi: 10.1007/s00296-025-05925-0.
Heart involvement in Systemic Sclerosis (SSc) remains among the leading causes of disease-related deaths. SSc has been associated with an increased risk of pericardial effusion (PerEff). The aim of our study was to examine the prevalence and identify possible factors associated with ever and persistent SSc-PerEff. For this retrospective study, consecutive patients with a diagnosis of SSc, that visited our Outpatient Unit until June 2024, were recruited. Demographic data, disease manifestations, serological profile, and internal organ involvement were collected. Initially, participants with at least one measurement of PerEff were enrolled. For the second step individuals with at least two echocardiograms were included and were classified into three groups: single, persistent and never PerEff. In total 290 adult patients (female-to-male ratio 5.6:1) were included. Results showed that 24.5% of the patients had at least one echocardiogram ever positive for PerEff and 13.2% exhibited persistent PerEff. In the multivariate analysis, ever PerEff was associated with the presence of pulmonary hypertension [PH, Odds ratio, (OR):3.22, p < 0.01], interstitial lung disease (ILD, OR:4.18, p < 0.01), telangiectasias (OR:4.25, p < 0.01) and elevated erythrocyte sedimentation rate (ESR, OR:2.01, p < 0.05). Persistent PerEff was, also, associated with PH (OR:2.90, p < 0.05), ILD (OR:6.65, p < 0.05), telangiectasias (OR:4.84, P < 0.05) and elevated ESR (OR:2.76, p < 0.05). PerEff is a common disease-related manifestation. Both ever and persistent PerEff were associated with PH, ILD, telangiectasias and increased inflammatory markers. The present study further supports the clinical significance of PerEff in SSc patients, with important implications in disease course and management.
心脏受累在系统性硬化症（SSc）中仍然是与疾病相关死亡的主要原因之一。SSc与心包积液（PerEff）风险增加有关。我们研究的目的是检查SSc-PerEff既往发生和持续存在的患病率，并确定与之相关的可能因素。在这项回顾性研究中，我们招募了截至2024年6月前来我们门诊就诊且诊断为SSc的连续患者。收集了人口统计学数据、疾病表现、血清学特征和内脏器官受累情况。最初，纳入至少有一次PerEff测量值的参与者。第二步，纳入至少有两次超声心动图检查结果的个体，并将其分为三组：单次出现、持续存在和从未出现PerEff。总共纳入了290名成年患者（女性与男性比例为5.6:1）。结果显示，24.5%的患者至少有一次超声心动图检查显示PerEff呈阳性，13.2%的患者存在持续性PerEff。在多变量分析中，既往出现PerEff与肺动脉高压（PH，比值比，OR：3.22，p<0.01）、间质性肺疾病（ILD，OR：4.18，p<0.01）、毛细血管扩张（OR：4.25，p<0.01）以及红细胞沉降率升高（ESR，OR：2.01，p<0.05）相关。持续性PerEff也与PH（OR：2.90，p<0.05）、ILD（OR：6.65，p<0.05）、毛细血管扩张（OR：4.84，P<0.05）以及ESR升高（OR：2.76，p<0.05）相关。PerEff是一种常见的与疾病相关的表现。既往出现和持续存在的PerEff均与PH、ILD、毛细血管扩张以及炎症标志物升高相关。本研究进一步支持了PerEff在SSc患者中的临床意义，对疾病进程和管理具有重要意义。
