title: Cardiac score. A semiquantitative measure of cardiac involvement that improves prediction of prognosis in systemic sclerosis.
abstract: Cardiac involvement, assessed yearly by a semiquantitative cardiac scoring technique (the sum of 2 variables, scored 0 or 1 for left axis deviation, and 0 or 2 for moderate-large pericardial effusion) and outcome at 10 years were evaluated in 90 systemic sclerosis (SSc) patients enrolled in a 3-year prospective drug trial. Higher cardiac scores were associated with decreased survival. The inverse relationship of survival with cardiac score was more significant than the relationship between survival and any of the cardiopulmonary variables individually (P less than 0.0000003). Predicted 6-year survival was 79% in patients with a cardiac score of 0, 51% in those with a score of 1, 15% in those with a score of 2, and 0% in those with a score of 3. We conclude that a simple 2-variable weighted cardiac score, derived from routine electrocardiography and echocardiography, is a useful predictor of survival in patients with SSc, and we propose that the application of this cardiac score be tested in other populations of SSc patients.
authors.affiliation: Department of Medicine, School of Medicine, University of California, Los Angeles.
authors.forename: P J
authors.initials: PJ
authors.lastname: Clements
authors.forename: P A
authors.initials: PA
authors.lastname: Lachenbruch
authors.forename: D E
authors.initials: DE
authors.lastname: Furst
authors.forename: H E
authors.initials: HE
authors.lastname: Paulus
authors.forename: M G
authors.initials: MG
authors.lastname: Sterz
mesh_terms: D000328:Adult; D006332:Cardiomegaly / Q000209:etiology; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology; D008171:Lung Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D013902:Radiography, Thoracic; D012595:Scleroderma, Systemic / Q000150:complications* / Q000401:mortality; D012720:Severity of Illness Index; D012871:Skin Diseases / Q000209:etiology; D015996:Survival Rate