{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T20:40:13Z","timestamp":1770756013942,"version":"3.50.0"},"reference-count":18,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"unspecified","delay-in-days":40,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,1,15]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Cardiac involvement is a major complication of systemic sclerosis (SSc), with myocardial fibrosis as a hallmark feature. Cardiovascular magnetic resonance (CMR) is used to detect cardiac involvement. However, the prognostic value of serial CMR monitoring and the effects of immunosuppressive therapy remain unclear. This study aimed to assess the prognostic significance of CMR parameter evolution for long-term cardiovascular outcomes and to evaluate the impact of immunosuppressive treatments on myocardial fibrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients from a single centre who underwent two CMR scans using the same protocol and equipment were included. CMR parameter evolution was compared using paired t-tests. The effects of treatments and changes in CMR parameters on the occurrence of major adverse cardiovascular events (MACE) and mortality were analysed using Kaplan-Meier curves and log-rank tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>44 patients were included with a median (IQR) follow-up duration of 6.3 (3.1\u20139.2) years. The median interval between CMR scans was 1.5 (1.0\u20133.9) years. Seven (16%) patients had diastolic dysfunction, and 16 (36%) patients experienced MACE. Rituximab significantly decreased maximal T1 values (p=0.029), a marker of diffuse myocardial fibrosis linked to an increased risk of all-cause death (p=0.044). A significant increase in left ventricular ejection fraction (p=0.032) and a lower risk of MACE (p=0.024) were observed in patients treated with methotrexate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Methotrexate was associated with reduced MACE risk, while rituximab decreased maximal T1 value, suggesting a reduction in diffuse myocardial fibrosis. These findings support the prognostic value of CMR monitoring and the potential benefit of immunosuppressive therapy in SSc-related cardiac involvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-006562","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T15:25:18Z","timestamp":1770737118000},"page":"e006562","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of serial cardiovascular magnetic resonance monitoring and immunosuppressive therapy in predicting outcomes in systemic sclerosis"],"prefix":"10.1136","volume":"12","author":[{"given":"A\u00efcha","family":"Kante","sequence":"first","affiliation":[{"name":"Service de M\u00e9decine Interne, Centre de R\u00e9f\u00e9rence Maladies Syst\u00e9miques Autoimmunes et Autoinflammatoires Rares d\u2019Ile de France de l\u2019Est et de l\u2019Ouest, H\u00f4pital Cochin, Assistance Publique-H\u00f4pitaux de Paris (APHP), Paris, France"},{"name":"APHP-CUP, H\u00f4pital Cochin, Universit\u00e9 Paris Cit\u00e9, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Mghaeith","sequence":"additional","affiliation":[{"name":"APHP-CUP, H\u00f4pital Cochin, Universit\u00e9 Paris Cit\u00e9, Paris, France"},{"name":"Radiology Department, H\u00f4pital Cochin, APHP, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertrand","family":"Dunogue","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne, Centre de R\u00e9f\u00e9rence Maladies Syst\u00e9miques Autoimmunes et Autoinflammatoires Rares d\u2019Ile de France de l\u2019Est et de l\u2019Ouest, H\u00f4pital Cochin, Assistance Publique-H\u00f4pitaux de Paris (APHP), Paris, France"},{"name":"APHP-CUP, H\u00f4pital Cochin, Universit\u00e9 Paris Cit\u00e9, Paris, 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