Overview
Secondary nonischemic congestive cardiomyopathy refers to heart muscle dysfunction not caused by coronary artery disease, often resulting from systemic diseases like autoimmune conditions 1. Systemic sclerosis (SSc), an autoimmune disease characterized by fibrosis and microvascular impairment, can affect the heart and lead to myocardial fibrosis, causing electrical inhomogeneity and arrhythmias 1.Diagnosis
Arrhythmias are frequent in patients with SSc 1.
Premature supraventricular and ventricular contractions are the most prevalent arrhythmias 1.
Right bundle branch block (RBBB) is the most frequent conduction disturbance 1.
Elevated N-terminal prohormones of brain natriuretic peptides (NT-pro BNP) are associated with various atrial and ventricular arrhythmias and RBBB 1.
A lower value of the turbulence slope (TS) is an independent predictor for ventricular arrhythmias 1.Management
Paraclinical and laboratory parameters can aid in early diagnosis 1.Key Recommendations
Monitor for arrhythmias and conduction disturbances in patients with systemic sclerosis 1.
Consider elevated NT-pro BNP levels as a marker associated with arrhythmias and RBBB in SSc 1.
Evaluate turbulence slope (TS) as a potential predictor for ventricular arrhythmias in SSc 1.References
1 Vrancianu CA, Gheorghiu AM, Popa DE, Chan JSK, Satti DI, Lee YHA et al.. Arrhythmias and Conduction Disturbances in Patients with Systemic Sclerosis-A Systematic Literature Review. International journal of molecular sciences 2022. link