Severe mitroaortic valve dysfunction prevalent in systemic sclerosis

Patients with systemic sclerosis (SSc) are more likely to experience moderate-to-severe mitral regurgitation (MR) and aortic stenosis (AS) than age-matched non-SSc controls with similar cardiovascular (CV) comorbidities, results of a case-control study have shown.

The investigators included 172 patients with SSc and 172 non-SSc adults without known cardiac disease matched by age, sex, and prevalence of CV risk factors. Transthoracic Doppler echocardiogram was performed to screen mitral and aortic valvular involvement. AS prevalence was also compared with that reported in a population-based study performed during the same period.

SSc patients had a nearly fivefold higher prevalence of moderate-to-severe mitroaortic valve dysfunction than non-SSc controls (odds ratio [OR], 4.60, 95 percent confidence interval [CI], 1.51–13.98; p=0.003). MR was the most common lesion, which was observed in 5.2 percent of patients, followed by AS in 3.5 percent and aortic regurgitation (AR) in 1.7 percent.

Separate analysis of the different types of valvular lesions revealed a significantly higher frequency of MR than controls (OR, 4.69, 95 percent CI, 1.12–22.04; p=0.032), as well as a higher frequency of AS in the 65–75 (OR, 7.51, 95 percent CI, 1.22–46.23; p=0.01) and 76–85 age groups (OR, 3.53, 95 percent CI, 1.03–12.22; p=0.043), relative to the general population.

“While results from this study do not allow for establishing a direct causal relationship, they strongly support the contribution of SSc-specific factors in the development of these complications,” the investigators said.