INTRODUCTION AND OBJECTIVES: Cardiac involvement in systemic sclerosis (SSc) patients affects mortality. Cardiac magnetic resonance (CMR) is capable of detecting structural changes, including diffuse myocardial fibrosis that may develop over time. Our aim was to evaluate myocardial structure and function changes using CMR in patients with SSc without known cardiac disease during a 5-year follow-up and find possible correlations with selected biomarkers. METHODS: A total of 25 patients underwent baseline and follow-up CMR examinations according to a pre-specified protocol. Standard biochemistry, five biomarkers (hsTnI, NT-proBNP, galectin-3, sST2, and GDF-15), and disease-specific functional parameters enabling the classification of disease severity were also measured. RESULTS: After five years, no patient suffered from manifest heart disease. Mean extracellular volume (ECV) and T1 mapping values did not change significantly (p ≥ 0.073). However, individual increases in native T1 time and ECV correlated with increased galectin-3 serum levels (r = 0.56; p = 0.0050, and r = 0.71; p = 0.0001, respectively). The progression of skin involvement assessed using the Rodnan skin score and a decrease in the diffusing capacity of the lungs were associated with increased GDF-15 values (r = 0.63; p = 0.0009, and r = -0.51; p = 0.011, respectively). CONCLUSIONS: During the 5-year follow-up, there was no new onset of heart disease observed in patients with SSc. However, in some patients, CMR detected progression of sub-clinical myocardial fibrosis that significantly correlated with elevated galectin-3 levels. GDF-15 values were found to be associated with disease severity progression.

Department of Cardiology University Hospital and Faculty of Medicine in Pilsen and Faculty Hospital Charles University Alej Svobody 80 304 60 Pilsen Czech Republic

Department of Clinical Biochemistry and Hematology University Hospital and Faculty of Medicine in Pilsen Alej Svobody 80 304 60 Pilsen Czech Republic

Department of Clinical Pharmacology Rheumatology University Hospital and Faculty of Medicine in Pilsen Charles University Edvarda Benese 1128 13 305 99 Pilsen Czech Republic

Department of Imaging Methods University Hospital and Faculty of Medicine in Pilsen Charles University Alej Svobody 80 304 60 Pilsen Czech Republic

Internal Department 2 University Hospital and Faculty of Medicine in Pilsen Charles University Edvarda Benese 1128 13 305 99 Pilsen Czech Republic

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