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The following is a summary of “Cardiogenic shock in systemic sclerosis: a retrospective study of acute ventricular dysfunction,” published in the April 2025 issue of Rheumatology International by Uribarri et al. 

Researchers conducted a retrospective study on cardiac involvement in systemic sclerosis (SSc), highlighting ventricular dysfunction and cardiogenic shock as key contributors to morbidity and mortality, with unclear causes of acute dysfunction. 

They included 10 patients with SSc admitted with cardiogenic shock and acute ventricular dysfunction between 2010 and 2023, excluding those with prior heart disease. Clinical, laboratory, imaging, and pathological data were analyzed, with outcomes assessed at 6 months. 

The results showed the cohort was 90% female, with a mean age of 58.8 ± 3.8 years. Most had diffuse cutaneous SSc (70%) and musculoskeletal involvement (50%), with an average disease duration of 4.8 ± 5.2 years. All patients had severe hemodynamic instability, with a mean systolic blood pressure of 78.4 ± 6.7 mmHg and elevated troponin levels (2,077 ± 3,379 ng/L). Pericardial effusion was observed in all, and 30% required pericardiocentesis. CMR showed late gadolinium enhancement, prolonged T2 relaxation time, and reduced ventricular function (LVEF 31 ± 8%). Biopsies revealed myocarditis with T lymphocyte and macrophage infiltration. In-hospital mortality was 60%. Among survivors, LVEF improved by 10 ± 10% in 6 months. 

Investigators found that patients with SSc who developed cardiogenic shock and acute ventricular dysfunction had high mortality and limited recovery. The phenotype was associated with diffuse cutaneous SSc and musculoskeletal involvement, likely driven by myocarditis. 

Source: link.springer.com/article/10.1007/s00296-025-05874-8