title: Prevalence and factors associated with left ventricular dysfunction in the EULAR Scleroderma Trial and Research group (EUSTAR) database of patients with systemic sclerosis.
abstract: 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.
authors.affiliation: Service de Rhumatologie A, Hôpital Cochin, Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France. yannick.allanore@cch.aphp.fr
authors.forename: Y
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authors.lastname: Allanore
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authors.lastname: Vonk
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authors.lastname: Hachulla
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authors.lastname: Caramaschi
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authors.lastname: Riemekasten
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authors.lastname: Cozzi
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authors.lastname: Beretta
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authors.lastname: Derk
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authors.lastname: Komócsi
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authors.lastname: Farge
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authors.lastname: Balbir
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authors.lastname: Riccieri
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authors.lastname: Distler
authors.forename: A
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authors.lastname: Chialà
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authors.lastname: Del Papa
authors.forename: K Pasalic
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authors.lastname: Simic
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authors.lastname: Ghio
authors.forename: B
authors.initials: B
authors.lastname: Stamenkovic
authors.forename: S
authors.initials: S
authors.lastname: Rednic
authors.forename: N
authors.initials: N
authors.lastname: Host
authors.forename: R
authors.initials: R
authors.lastname: Pellerito
authors.forename: E
authors.initials: E
authors.lastname: Zegers
authors.forename: A
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authors.lastname: Kahan
authors.forename: U A
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authors.lastname: Walker
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authors.lastname: Matucci-Cerinic
mesh_terms: 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
chemical_list: D002121:Calcium Channel Blockers