Primary cardiac involvement (SSc-PHI) in systemic sclerosis is an important prognostic factor. We aimed to characterize and identify subclinical SSc-PHI using cardiovascular MRI to determine whether disease severity and serum biomarkers are associated with subclinical SSc-PHI. A total of 26 patients with SSc who had no history of cardiovascular disease or pulmonary hypertension underwent 3 T-enhanced cardiovascular MRI. Measurements included native T, extracellular volume, advanced gadolinium enhancement, T mapping, and left ventricular volume function. Troponin T and N telencephalic natriuretic peptide precursors were also determined. LGE was observed in 13 of 26 patients (50.0%), suggesting focal fibrosis, and T mapping was significantly higher in the dcSSc group than in the lcSSc group (=0.009). Left ventricular volume and function were within the normal range in all patients, but final systolic left ventricular volume was significantly higher in dcSSc than in lcSSc (=0.021). The modified Rodnan skin score (mRSS) was significantly higher in patients with LGE focal fibrosis (=0.019). Logistic regression analysis confirmed the association between mRSS and LGE (=1.224, =0.037). In multivariate analysis, T mapping was negatively correlated with disease course, and was correlated with dcSSc and fingertip ulcer (=0.711, =0.018, =0.013, =0.030). Troponin T was correlated with T mapping (=0.555, =0.049). Subclinical SSc-PHI is characterized by diffuse and focal myocardial fibrosis, but preserves myocardial systolic function. Subclinical SSC-Phi is associated with TNT, SSc disease severity, and complex peripheral vascular disease. These data provide information for identifying individuals at risk of SSc-PHI.

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http://dx.doi.org/10.3760/cma.j.cn112138-20231101-00277DOI Listing

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