{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:09:49Z","timestamp":1792714189595,"version":"4.5.0"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Systemic sclerosis (SSc) primary heart involvement (SSc\u2010pHI) is one of the leading causes of mortality in SSc. We aimed to evaluate risk factors for SSc\u2010pHI and its progression and the outcomes in the EUSTAR (European Scleroderma Trials and Research) cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">SSc\u2010pHI was defined according to the World Scleroderma Foundation\/Heart Failure Association definition. Data from 5741 patients with SSc in the EUSTAR cohort were analyzed. Additional cardiovascular data were collected from a subcohort of 838 patients with SSc. Lasso regression was used for risk factor analyses. Kaplan\u2013Meier estimator was used for survival analyses. Progression of SSc\u2010pHI was evaluated by a study definition developed by rheumatology and cardiology experts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Risk factors for the presence of SSc\u2010pHI comprised skeletal muscle atrophy (odds ratio [OR], 2.00 [95% CI, 1.00\u20132.68]), age (OR, 1.91 [95% CI, 1.73\u20132.03]), male sex (OR, 1.77 [95% CI, 1.42\u20132.05]), swollen joints (OR, 1.70 [95% CI, 1.47\u20131.98]), skeletal muscle weakness (OR, 1.38 [95% CI, 1.00\u20131.85]), and tendon friction rubs (OR, 1.46 [95% CI, 1.00\u20131.77]) (n=3276). Telangiectasia (OR, 2.10 [95% CI, 1.38\u20132.72]), intestinal symptoms (OR, 1.70 [95% CI, 1.04\u20132.42]), age (OR, 1.47 [95% CI, 1.21\u20131.62]), and antitopoisomerase I antibodies (OR, 1.37 [95% CI, 1.00\u20131.77]) were associated with an increased risk for new onset of SSc\u2010pHI (n=1000). Survival rate was significantly lower in patients with SSc\u2010pHI than in those without (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      value &lt;0.0001, n=3768). Patients with SSc\u2010pHI had a lower survival rate than patients with interstitial lung disease (n=3365). Swollen joints were associated with an increased risk of progressive SSc\u2010pHI (OR, 2.49 [95% CI, 1.79\u20133.52]) (n=595). Tendon friction rubs (OR, 1.21 [95% CI, 0.94\u20131.90]) increased the risk of heart failure with preserved ejection fraction in patients with SSc\u2010pHI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">We defined progressive SSc\u2010pHI and identified risk factors for new onset and progression of SSc\u2010pHI and for SSc\u2010pHI\u2010associated heart failure with preserved ejection fraction in the largest cohort with SSc. These findings may guide patient stratification for diagnostic workup and therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.036730","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T06:03:49Z","timestamp":1740549829000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Evaluation of Systemic Sclerosis Primary Heart Involvement and Chronic Heart Failure in the European Scleroderma Trials and Research Cohort"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4960-3369","authenticated-orcid":false,"given":"Andrea\u2010Hermina","family":"Gy\u00f6rfi","sequence":"first","affiliation":[{"name":"University Hospital D\u00fcsseldorf, Medical Faculty of Heinrich\u2010Heine University","place":["D\u00fcsseldorf, Germany"]},{"name":"University Hospital D\u00fcsseldorf, Medical Faculty of Heinrich\u2010Heine 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