Left ventricular (LV) diastolic dysfunction (LVDD) in systemic sclerosis (SSc)-associated interstitial lung disease (ILD) shows a greater association with traditional LVDD than SSC-specific risk factors, reveals a study. Of note, SSc-ILD patients with LVDD appear to have worse dyspnoea and survival.
A total of 102 patients with definite SSc and radiographic ILD from the Australian Scleroderma Cohort Study were included in the current analysis. Diastolic function was categorized as normal, indeterminate, or abnormal based on the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines for LV diastolic function assessment.
Using logistic regression, the authors explored the relationship between clinical features and patient- and physician-reported dyspnoea. They also conducted survival analyses using Kaplan-Meier survival estimates and Cox regression modelling.
Of the participants, 26 percent had LVDD, while 19 percent and 55 percent had indeterminate and normal diastolic function, respectively. Those with both ILD and LVDD were at higher risk of death (hazard ratio, 2.4, 95 percent confidence interval [CI], 1.0‒5.7; p=0.05).
After adjusting for age and sex, ILD patients with LVDD showed a greater predisposition to severe dyspnoea on the Borg Dyspnoea Scale (odds ratio [OR], 2.6, 95 percent CI, 1.0‒6.6; p=0.05) and to World Health Organization Function Class II or higher dyspnoea (OR, 4.2, 95 percent CI, 0.9‒20.0; p=0.08).
The following factors were significantly associated with LVDD: older age (95 percent CI, 1.0‒6.4; p=0.05), hypertension (OR, 5.0, 95 percent CI, 1.8‒13.8; p<0.01), ischaemic heart disease (OR, 4.8, 95 percent CI, 1.5‒15.7; p<0.01), proximal muscle atrophy (OR, 5.0, 95 percent CI, 1.9‒13.6; p<0.01), and multimorbidity (Charlson Comorbidity Index scores ≥4; OR, 3.0, 95 percent CI, 1.1‒8.7; p=0.04).