Consensus best practice pathway of the UK Systemic Sclerosis Study group: management of cardiac disease in systemic sclerosis.
Cardiac disease in SSc can manifest in various ways and is associated with a poor prognosis. There is little evidence on how best to detect and manage cardiac disease in SSc. Our objective was to produce an expert consensus best practice pathway for the management of cardiac disease in SSc.



The UK Systemic Sclerosis Study Group set up several working groups to develop a number of consensus best practice pathways for the management of SSc-specific complications, including cardiac disease. A multidisciplinary task force was convened. The guidelines were partly informed by a comprehensive literature review.



A best practice pathway for cardiac disease (with a focus on primary cardiac disease) in SSc is presented, including approaches for early detection and standard pharmacological and device therapies. Due to the benefits, shared care and a multidisciplinary approach are recommended. A future research agenda has been formulated in response to the relative lack of understanding of the natural history of primary cardiac disease that was highlighted by the initiative.



The physician should be alert to the possibility of cardiac disease in SSc; it is best managed within a multidisciplinary team including both rheumatologists and cardiologists. This pathway provides a reference for all physicians managing patients with SSc.
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds.|NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds.
Lesley-Anne
LA
Bissell
Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool.
Marina
M
Anderson
Department of Cardiology, Aintree University Hospital, Liverpool.
Malcolm
M
Burgess
Centre for Rheumatology and Connective Tissue Diseases, Royal Free Hospital, London.
Kuntal
K
Chakravarty
Department of Cardiology, Royal Free Hospital, London.
Gerry
G
Coghlan
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds.|NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds.
Raluca B
RB
Dumitru
Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds.
Lee
L
Graham
Centre for Rheumatology and Connective Tissue Diseases, Royal Free Hospital, London.
Voon
V
Ong
Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath.
John D
JD
Pauling
Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds.
Sven
S
Plein
Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds.
Dominik
D
Schlosshan
Department of Cardiology Medicine, Salford Royal NHS Foundation Trust, Salford, UK.
Peter
P
Woolfson
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds.|NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds.
Maya H
MH
Buch
D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*; D002317:Cardiovascular Agents / Q000009:adverse effects; D004562:Electrocardiography; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D018810:Magnetic Resonance Angiography; D008487:Medical History Taking / Q000379:methods; D018670:Monitoring, Ambulatory / Q000379:methods; D010348:Patient Care Team / Q000458:organization & administration; D010493:Pericarditis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D010808:Physical Examination / Q000379:methods; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000175:diagnosis / Q000628:therapy*
D015415:Biomarkers; D002317:Cardiovascular Agents
cardiac disease; cardiomyopathy; primary myocardial disease; scleroderma; systemic sclerosis