MINI REVIEW article
Front. Med.
Sec. Rheumatology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1606593
This article is part of the Research TopicCardiovascular Comorbidities in Inflammatory Rheumatic DiseasesView all 12 articles
Cardiac Magnetic Resonance in systemic sclerosis: imaging features and potential prognostic implications. A literature review
Provisionally accepted
- 1Cardiology Unit, Ospedale Santa Maria della Scaletta, Imola, Bologna, Italy, Imola, Italy
- 2Service of Rheumatology. Department of Medicine and Oncology, Ospedale Santa Maria della Scaletta, Imola, Bologna, Italy, Imola, Italy
- 3Department of Pediatric and Adult Cardio-Thoracovascular, Oncohematologic and Emergencies Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy, Bologna, Italy
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Systemic sclerosis (SSc) is a chronic, multisystem disorder characterized by vascular dysfunction, immune dysregulation with production of autoantibodies, fibroblasts dysfunction and consequent abnormal collagen production, leading to progressive fibrosis of the skin and various organs. Cardiac involvement is common, affecting the myocardium, pericardium, valvular structures and conduction tissue, even though it is often unrecognized. Despite this, it is a major determinant of morbidity and mortality in SSc, being responsible for about 15% of all deaths. Due to the relevant prognostic implications of cardiac involvement its early detection is mandatory. A comprehensive screening through a multimodality approach is required in all patients with SSc, even in those without overt cardiac symptoms. Cardiac magnetic resonance (CMR) is now considered the gold standard for non-invasive detection of the myocardial disease SSc related. It provides not only a morphological and functional assessment, but also offers an ultrastructural definition of the myocardium, particularly by the detection of fibrosis and myocardial inflammation (MI), unmasking an initial myocardial involvement since the early stage of disease. The aim of this review is to describe the potential spectrum of cardiac involvement in SSc, and to highlight central role of CMR in its detection, offering a comprehensive description of the imaging features and their prognostic implication.
Keywords: cardiac magnetic resonance, Medicine, systemic sclerosis, pulmonary arterial hypertension, prognostic factors, Myocardial inflammation
Received: 05 Apr 2025; Accepted: 24 Jul 2025.
Copyright: © 2025 Vitale, Colina, Attinà, Niro and Ortolani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Giovanni Vitale, Cardiology Unit, Ospedale Santa Maria della Scaletta, Imola, Bologna, Italy, Imola, Italy
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