Prevalence and factors associated with left ventricular dysfunction in the EULAR Scleroderma Trial and Research group (EUSTAR) database of patients with systemic sclerosis.
OBJECTIVE
To measure the prevalence of, and factors associated with, left ventricular (LV) dysfunction in systemic sclerosis (SSc).


METHODS
The EUSTAR database was first searched. A case-control study of a patient subset was then performed to further identify independent factors associated with LV dysfunction by simple and multiple regression.


RESULTS
Of 7073 patients, 383 (5.4%) had an LV ejection fraction (EF) of <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 were associated with LV dysfunction. In the second phase, 129 patients with SSc with LVEF <55% were compared with 256 patients with SSc with normal LVEF. Male sex (OR 3.48; 95% CI 1.74 to 6.98), age (OR 1.03; 95% CI 1.01 to 1.06), digital ulcerations (OR 1.91; 95% CI 1.05 to 3.50), myositis (OR 2.88; 95% CI 1.15 to 7.19) and use of calcium channel blockers (OR 0.41; 95% CI 0.22 to 0.74) were independent factors associated with LV dysfunction.


CONCLUSIONS
The prevalence of LV dysfunction in SSc is 5.4%. Age, male gender, digital ulcerations, myositis and lung involvement are independently associated with an increased prevalence of LV dysfunction. Conversely, the use of calcium channel blockers may be protective.
Allanore
Y
Y
Service de Rhumatologie A, Hôpital Cochin, Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France. yannick.allanore@cch.aphp.fr
Meune
C
C
Vonk
M C
MC
Airo
P
P
Hachulla
E
E
Caramaschi
P
P
Riemekasten
G
G
Cozzi
F
F
Beretta
L
L
Derk
C T
CT
Komócsi
A
A
Farge
D
D
Balbir
A
A
Riccieri
V
V
Distler
O
O
Chialà
A
A
Del Papa
N
N
Simic
K Pasalic
KP
Ghio
M
M
Stamenkovic
B
B
Rednic
S
S
Host
N
N
Pellerito
R
R
Zegers
E
E
Kahan
A
A
Walker
U A
UA
Matucci-Cerinic
M
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004812:Epidemiologic Methods; D005060:Europe / Q000453:epidemiology; D005260:Female; D005385:Fingers; D006801:Humans; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000150:complications / Q000453:epidemiology; D012595:Scleroderma, Systemic / Q000150:complications* / Q000453:epidemiology; D012737:Sex Factors; D012883:Skin Ulcer / Q000150:complications / Q000453:epidemiology; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control
D002121:Calcium Channel Blockers