{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:28:07Z","timestamp":1787304487388,"version":"build-2736575974"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the role of a multimodality imaging approach in detecting subclinical cardiac impairment in systemic sclerosis (SSc) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 2017 and 2019 we retrospectively collected data related to 50 consecutive SSc patients who underwent Doppler echocardiography and cardiac magnetic resonance (CMR). The data was compared with 50 controls matched for age, sex and cardiovascular risk predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CMR revealed late gadolinium enhancement (LGE) (30% vs. 8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), myocardial edema (14% vs. 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), and pericardial effusion (18% vs. 4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026) in a significantly higher number of SSc subjects, compared to matched controls. A positive linear correlation has been observed between disease duration and LGE progression from basal to apical left ventricular segments (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.82,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The lower the ejection fraction, the longer the disease duration (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.69,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), and the higher the number of LGE segments (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.78,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Multivariate analysis confirmed disease duration as independent predictor of myocardial fibrosis after adjustment for confounders (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), as well as the independent association of both LGE and disease duration with impaired left ventricular ejection fraction in SSc subjects (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Doppler echocardiography showed a significantly lower E\/A ratio (1.0\u2009\u00b1\u20090.3 vs. 1.3\u2009\u00b1\u20090.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), higher E\/e\u2019 ratio (10.9\u2009\u00b1\u20092.5 vs. 6.8\u2009\u00b1\u20091.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001) and systolic peak tricuspid regurgitation velocity (2.7\u2009\u00b1\u20090.6\u2005m\/s vs. 2.3\u2009\u00b1\u20090.5\u2005m\/s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) among SSc patients compared to controls. LGE-positive SSc subjects showed a higher E\/e\u2019 ratio compared to other SSc patients (13.5\u2009\u00b1\u20092.4 vs. 9.7\u2009\u00b1\u20091.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These data confirm the significant prevalence of imaging findings of subtle cardiac impairment in SSc patients, thus suggesting the role of multimodality imaging by Doppler echocardiography and CMR as a potential screening approach in this subset population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1935675","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:10:25Z","timestamp":1787303425000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimodality imaging approach in cardiac asymptomatic subjects with systemic sclerosis followed at a tertiary center"],"prefix":"10.3389","volume":"13","author":[{"given":"Riccardo","family":"Scagliola","sequence":"first","affiliation":[{"name":"Cardiology Division, Cardinal G. Massaia Hospital","place":["Asti, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Marco","family":"Rosa","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Unit, University of Genoa","place":["Genoa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Seitun","sequence":"additional","affiliation":[{"name":"Radiology Division, San Martino Hospital","place":["Genoa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Puppo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Genoa","place":["Genoa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Brunelli","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Unit, University of Genoa","place":["Genoa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"993","DOI":"10.4330\/wjc.v6.i9.993","article-title":"Cardiac manifestations in systemic sclerosis","volume":"6","author":"Lambova","year":"2014","journal-title":"World J Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1016\/j.repc.2017.07.022","article-title":"Early manifestation of myocardial involvement in systemic sclerosis","volume":"38","author":"Marques-Alves","year":"2019","journal-title":"Rev Port Cardiol (Engl Ed)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1016\/j.case.2023.03.006","article-title":"Rapidly progressive primary scleroderma cardiomyopathy in a young adult characterized by multimodality imaging","volume":"7","author":"Maidman","year":"2023","journal-title":"CASE (Phila)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1177\/23971983241313096","article-title":"Cardiac involvement in systemic sclerosis: a critical review of knowledge gaps and opportunities","volume":"10","author":"Jones","year":"2025","journal-title":"J Scleroderma Relat Disord"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1177\/2047487320916591","article-title":"Subclinical progression of systemic sclerosis-related cardiomyopathy","volume":"27","author":"Stronati","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"617.e1","DOI":"10.1016\/j.repc.2015.02.005","article-title":"Systemic sclerosis: a rare cause of heart failure?","volume":"34","author":"Gonz\u00e1lez-Cambeiro","year":"2015","journal-title":"Rev Port Cardiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1016\/j.semarthrit.2004.11.001","article-title":"Echocardiographic alterations in systemic sclerosis: a longitudinal study","volume":"34","author":"Maione","year":"2005","journal-title":"Semin Arthritis Rheum"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e14110","DOI":"10.1016\/j.heliyon.2023.e14110","article-title":"Association between systemic sclerosis and left ventricle dysfunction: findings from observational studies","volume":"9","author":"Yan","year":"2023","journal-title":"Heliyon"},{"key":"B9","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1515\/rir-2024-0011","article-title":"Cardiac magnetic resonance imaging in systemic sclerosis: heart involvement in high-resolution","volume":"5","author":"Fairley","year":"2024","journal-title":"Rheumatol Immunol Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1606593","DOI":"10.3389\/fmed.2025.1606593","article-title":"Cardiac magnetic resonance in systemic sclerosis: imaging features and potential prognostic implications. 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