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While cardiac disease can be clinically silent and only diagnosed in autopsy, new imaging modalities such as speckle-tracking echocardiography and cardiovascular magnetic resonance may reveal various abnormal findings in the majority of patients. Cardiovascular magnetic resonance evaluation should include assessment of left and right ventricular function, inflammation (STIR T2-weighted sequences (T2-W) for edema detection), and fibrosis (T1-weighted sequences 15\u2009min after Gd-DTPA contrast medium injection (late-gadolinium enhancement). Notably, cardiac disease is responsible for about one-fourth of systemic sclerosis\u2013related deaths. Systematic studies for the assessment and therapy of systemic sclerosis\u2013related cardiac complications, as well as relevant guidelines from the European League Against Rheumatism and the American College of Rheumatology, are currently lacking. However, research advances reviewed herein allow for a better understanding of the mechanisms that alter cardiac function. Implementation of such knowledge should reduce cardiac morbidity and mortality in systemic sclerosis patients.<\/jats:p>","DOI":"10.1177\/2397198317747441","type":"journal-article","created":{"date-parts":[[2018,4,5]],"date-time":"2018-04-05T01:24:41Z","timestamp":1522891481000},"page":"53-65","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":38,"title":["Update on assessment and management of primary cardiac involvement in systemic sclerosis"],"prefix":"10.1136","volume":"3","author":[{"given":"Vasiliki-Kalliopi","family":"Bournia","sequence":"first","affiliation":[{"name":"First Department of Propaedeutic and Internal Medicine and Joined Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Laikon Hospital, Athens - Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Tountas","sequence":"additional","affiliation":[{"name":"First Department of 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