In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to EACVI Silver Members, Fellows of the ESC and Young combined Members

Prognostic value of cardiac magnetic resonance in systemic sclerosis

Session Poster session 1

Speaker Alessia Pepe

Congress : EuroCMR 2019

  • Topic : imaging
  • Sub-topic : Cardiac Magnetic Resonance
  • Session type : Poster Session
  • FP Number : P137

Authors : A Pepe (Pisa,IT), A Meloni (Pisa,IT), C Bruni (Florence,IT), D De Marchi (Pisa,IT), G Todiere (Pisa,IT), F Fulgenzi (Chieti,IT), Y Ghebru (Chieti,IT), S Guiducci (Florence,IT), R De Caterina (Pisa,IT), M Matucci Cerinic (Florence,IT), L Gargani (Pisa,IT)

A Pepe1 , A Meloni1 , C Bruni2 , D De Marchi1 , G Todiere1 , F Fulgenzi3 , Y Ghebru3 , S Guiducci2 , R De Caterina4 , M Matucci Cerinic2 , L Gargani5 , 1Fondazione Toscana Gabriele Monasterio - Pisa - Italy , 2University of Florence - Florence - Italy , 3University of Chieti-Pescara - Chieti - Italy , 4University of Pisa - Pisa - Italy , 5Institute of Clinical Physiology, CNR - Pisa - Italy ,

European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 2 ), ii81

Background: Cardiac involvement, often subclinical, is frequent in patients with systemic sclerosis (SS), and significantly affects prognosis. Cardiac magnetic resonance (CMR) is the non-invasive gold standard to quantify biventricular functional parameters and to allow myocardial tissue characterization.

Purpose: To evaluate the prognostic value of CMR for cardiac events in SS.

Methods: Two hundred and seventy-three SS patients with a thorough clinical assessment underwent CMR imaging using a 1.5 T GE scanner. We quantified biventricular function parameter by steady-state free precession (SSFP) cine images, edema by short inversion time inversion recovery (STIR) T2 images, and macroscopic fibrosis by late gadolinium enhancement (LGE). Patients were followed-up for subsequent cardiac events, including new-onset pulmonary arterial hypertension (PAH), new-onset heart failure (HF), and new-onset severe arrhythmias (sustained ventricular tachycardia or fibrillation).

Results: The mean follow-up was 23.9 ± 17.0 months. During follow-up, a total of 14 cardiac events occurred in 14 different patients (3 new-onset PAH, 5 new-onset HF, 6 ventricular tachycardias). CMR predictors of cardiac events at univariate analysis were left and right ventricular ejection fractions, indexed left and right atrial areas, and LGE (see Table). Myocardial fibrosis by LGE was the only independent predictor at multivariate analysis (hazard ratio 3.175; 95% C.I. 1.021-9.870, see Figure).

Conclusions: Cardiac magnetic resonance anatomical and functional parameters of both the left and right heart have significant prognostic value in patients with SS.

Univariate analysis Multivariate analysis

HR (95% CI)


HR (95% CI)

Left Ventricular Ejection Fraction 0.904 (0.843 - 0.969) 0.004 0.935 (0.868 - 1.007) 0.075
Indexed Left Atrial Area 1.244 (1.002 - 1.546) 0.048
Right Ventricular Ejection Fraction 0.926 (0.884 - 0.969) 0.001 0.958 (0.904 - 1.014) 0.139
Indexed Right Atrial Area 1.384 (1.059 - 1.809) 0.017
Right Ventricular End-Diastolic Mass 1.039 (0.991 - 1.091) 0.115
Right Ventricular End-Systolic Mass 1.036 (0.988 - 1.086) 0.148
T2 ratio 0.247 (0.019 - 3.251) 0.288
Late Gadolinium Enhancement 3.871 (1.289 - 11.623) 0.016 3.175 (1.021-9.870) 0.046

The free consultation period for this content is over.

It is now only available year-round to EACVI Silver Members, Fellows of the ESC and Young combined Members

Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from ESC Congress and ESC Asia with APSC & AFC
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s congress resources
  • 3Under 40 or in training - with a Combined Membership, access resources from all congresses
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are