Are troponin and B-type natriuretic peptides useful biomarkers for the diagnosis of systemic sclerosis heart involvement? A systematic literature review

Introduction: Primary heart involvement in systemic sclerosis may cause morpho-functional and electrical cardiac abnormalities and is a common cause of death. The absence of a clear definition of primary heart involvement in systemic sclerosis limits our understanding and ability to focus on clinical research. We aimed to create an expert consensus definition for primary heart involvement in systemic sclerosis. Methods: A systematic literature review of cardiac involvement and manifestations in systemic sclerosis was conducted to inform an international and multi-disciplinary task force. In addition, the nominal group technique was used to derive a definition that was then subject to voting. A total of 16 clinical cases were evaluated to test face validity, feasibility, reliability and criterion validity of the newly created definition. Results: In total, 171 publications met eligibility criteria. Using the nominal group technique, experts added their opinion, provided statements to consider and ranked them to create the consensus definition, which received 100% agreement on face validity. A median 60(5–300) seconds was taken for the feasibility on a single case. Inter-rater agreement was moderate (mKappa (95% CI) = 0.56 (0.46–1.00) for the first round and 0.55 (0.44–1.00) for the second round) and intra-rater agreement was good (mKappa (95% CI) = 0.77 (0.47–1.00)). Criterion validity showed a 78 (73–84)% correctness versus gold standard. Conclusion: A preliminary primary heart involvement in systemic sclerosis consensus-based definition was created and partially validated, for use in future clinical research.

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Ultrasonographic Imaging of Systemic Sclerosis Digital Ulcers: A systematic Literature review and Validation Steps

Seminars in Arthritis and Rheumatism ◽

10.1016/j.semarthrit.2021.02.008 ◽

2021 ◽

Author(s):

Yossra Suliman ◽

Cosimo Bruni ◽

Michael Hughes ◽

Marco Matucci-Cerinic ◽

Daniel E. Furst

Keyword(s):

Systemic Sclerosis ◽

Literature Review ◽

Systematic Literature Review ◽

Digital Ulcers

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AB0694 IS DUROMETRY A RELIABLE TOOL TO INVESTIGATE SKIN HARDNESS IN SYSTEMIC SCLEROSIS? A PILOT STUDY AND SYSTEMATIC LITERATURE REVIEW

10.1136/annrheumdis-2019-eular.2547 ◽

2019 ◽

Author(s):

Amber Vanhaecke ◽

Maurizio Cutolo ◽

Sven Verschuere ◽

Greta Pacini ◽

Veronica Vilela ◽

...

Keyword(s):

Systemic Sclerosis ◽

Pilot Study ◽

Literature Review ◽

Systematic Literature Review ◽

Reliable Tool

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Defining Skin Ulcers in Systemic Sclerosis: Systematic Literature Review and Proposed World Scleroderma Foundation (WSF) Definition

Journal of Scleroderma and Related Disorders ◽

10.5301/jsrd.5000236 ◽

2017 ◽

Vol 2 (2) ◽

pp. 115-120 ◽

Cited By ~ 35

Author(s):

Yossra Atef Suliman ◽

Cosimo Bruni ◽

Sindhu R. Johnson ◽

Emanuela Praino ◽

Mohamed Alemam ◽

...

Keyword(s):

Systemic Sclerosis ◽

Literature Review ◽

Systematic Literature Review ◽

Skin Ulcers

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Nailfold Videocapillaroscopy in Systemic Sclerosis–related Pulmonary Arterial Hypertension: A Systematic Literature Review

The Journal of Rheumatology ◽

10.3899/jrheum.190296 ◽

2019 ◽

Vol 47 (6) ◽

pp. 888-895 ◽

Cited By ~ 3

Author(s):

Vanessa Smith ◽

Amber Vanhaecke ◽

Els Vandecasteele ◽

Miguel Guerra ◽

Sabrina Paolino ◽

...

Keyword(s):

Systemic Sclerosis ◽

Pulmonary Arterial Hypertension ◽

Literature Review ◽

Arterial Hypertension ◽

Systematic Literature Review ◽

Capillary Density ◽

Nailfold Videocapillaroscopy ◽

Pulmonary Arterial ◽

Current Screening

Objective.Pulmonary arterial hypertension (PAH) is one of the leading causes of death in systemic sclerosis (SSc). Current screening algorithms are hampered by low positive predictive values. Outcome measures that could add to performance characteristics would be welcome. We aim to evaluate the role of nailfold videocapillaroscopy (NVC) using standardized definitions, in SSc-related PAH (SSc-PAH).Methods.A systematic review to identify original research papers documenting an association between NVC and right heart catheterization-defined SSc-PAH was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Subsequently, NVC characteristics were subdivided into quantitative (capillary density, dimension, morphology, and hemorrhages), semiquantitative, and qualitative assessment (NVC pattern), according to the definitions of the European League Against Rheumatism Study Group on Microcirculation in Rheumatic Diseases.Results.The systematic search identified 316 unique search results, of which 5 were included in the final qualitative analysis. The occurrence of incident SSc-PAH unequivocally associated in 2 longitudinal studies with progressive capillary loss (p = 0.04 and p = 0.033) and the progression to a severe (active/late) NVC pattern (p = 0.05/0.01 and HR = 5.12, 95% CI 1.23–21.27). In 3 cross-sectional studies, SSc-PAH was found to be unequivocally inversely associated with capillary density (p = 0.001 and p < 0.05) and associated with the presence of a severe NVC pattern (p = 0.03 and p < 0.05).Conclusion.This is the first systematic literature review investigating the role of NVC in SSc-PAH using standardized description, to our knowledge. Unequivocal associations were found between (incident) SSc-PAH and capillary density and NVC pattern. Integration of NVC into current screening algorithms to boost their performance may be a future step.

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