ARRHYTHMIC BURDEN, MYOCARDIAL MARKERS, AND LONG-TERM SURVIVAL IN DISTINCT CARDIAC MAGNETIC RESONANCE SUBSETS OF SYSTEMIC SCLEROSIS

Background: Cardiac involvement in Systemic Sclerosis (SSc) is widely recognized as heterogeneous and, when clinically evident, it is associated with a poor prognosis. Recently, five cardiac magnetic resonance (CMR) phenotypes in SSc have been identified [1]. These phenotypes do not align with the existing clinical subgroup classifications or autoantibody statuses, yet each has a distinct 5-year prognosis. Objectives: Our objective is to test the long-term prognostic significance of this classification system in an external cohort and to compare ECG Holter monitor parameters, NT-proBNP, and troponin T levels across these groups. Methods: CMR assessments were conducted on consecutive SSc patients who presented symptoms of dyspnoea, palpitations, or chest pain. Based on the CMR findings, patients were categorized into five distinct groups: those with dilated right hearts with right ventricular failure (RVF); biventricular failure with dilatation and dysfunction (BVF); and those with normal function, categorized further based on cavity sizes as average cavity (NF-AC), small cavity (NF-SC), and large cavity (NF-LC). The study focused on comparing clinical characteristics, serum troponin and NT-proBNP levels, ECG Holter monitor parameters, and 10-year survival outcomes across these groups. Results: Table 1 presents the clinical characteristics and assessed parameters of the 65 enrolled patients across the CMR subsets. The distributions for NF-AC, BVF, NF-SC, NF-LC, and RVF were 43.1%, 21.5%, 16.9%, 15.5%, and 3.1%, respectively. The duration of SSc was the only disease characteristic that showed statistically significant differences across the subsets. Troponin T and NT-proBNP values were similar across all subsets. The NF-LC and RVF groups exhibited Left Bundle Branch Block (LBB) more frequently and tended to present more ventricular ectopic beats (VEB) compared to other groups. There was a variation in 10-year survival rates across the groups, with patients in the RVF, NF-LC, and BVF categories showing poorer prognosis (Figure 1). Conclusion: This data confirms the prognostic value of the proposed CMR subsets in an another European SSc cohort, highlighting that subsets with poorer prognosis are associated with a higher arrhythmic burden. REFERENCES: [1] Daniel S Knight, Nina Karia, Alice R Cole, Rory H Maclean, James T Brown, Ambra Masi, Rishi K Patel, Yousuf Razvi, Liza Chacko, Lucia Venneri, Tushar Kotecha, Ana Martinez-Naharro, Peter Kellman, Ann M Scott-Russell, Benjamin E Schreiber, Voon H Ong, Christopher P Denton, Marianna Fontana, J Gerry Coghlan, Vivek Muthurangu, Distinct cardiovascular phenotypes are associated with prognosis in systemic sclerosis: a cardiovascular magnetic resonance study, European Heart Journal - Cardiovascular Imaging, Volume 24, Issue 4, April 2023, Pages 463–471, https://doi.org/10.1093/ehjci/jeac120 . Acknowledgements: NIL. Disclosure of Interests: None declared. DOI: 10.1136/annrheumdis-2024-eular.4809 Keywords: Magnetic Resonance Imaging, Cardiovascular diseases, Heart, Imaging Citation: , volume 83, supplement 1, year 2024, page 167Session: Clinical Abstract Sessions: Systemic Sclerosis - Imaging and biomarkers (Oral Abstract Presentations)

Magnetic Resonance Imaging, Cardiovascular diseases, Heart, Imaging