Cardiac magnetic resonance in systemic sclerosis: imaging features and potential prognostic implications. A literature review

Systemic sclerosis (SSc) is a chronic, multisystem disorder characterized by vascular dysfunction, immune dysregulation with production of autoantibodies, fibroblasts dysfunction and consequent abnormal collagen production, leading to progressive fibrosis of the skin and various organs. Cardiac invo...

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Main Authors: Giovanni Vitale, Matteo Colina, Domenico Attinà, Fabio Niro, Paolo Ortolani
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1606593/full
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author Giovanni Vitale
Matteo Colina
Domenico Attinà
Fabio Niro
Paolo Ortolani
author_facet Giovanni Vitale
Matteo Colina
Domenico Attinà
Fabio Niro
Paolo Ortolani
author_sort Giovanni Vitale
collection DOAJ
description Systemic sclerosis (SSc) is a chronic, multisystem disorder characterized by vascular dysfunction, immune dysregulation with production of autoantibodies, fibroblasts dysfunction and consequent abnormal collagen production, leading to progressive fibrosis of the skin and various organs. Cardiac involvement is common, affecting the myocardium, pericardium, valvular structures and conduction tissue, even though it is often unrecognized. Despite this, it is a major determinant of morbidity and mortality in SSc, being responsible for about 15% of all deaths. Due to the relevant prognostic implications of cardiac involvement its early detection is mandatory. A comprehensive screening through a multimodality approach is required in all patients with SSc, even in those without overt cardiac symptoms. Cardiac magnetic resonance (CMR) is now considered the gold standard for non-invasive detection of the myocardial disease SSc related. It provides not only a morphological and functional assessment, but also offers an ultrastructural definition of the myocardium, particularly by the detection of fibrosis and myocardial inflammation (MI), unmasking an initial myocardial involvement since the early stage of disease. The aim of this review is to describe the potential spectrum of cardiac involvement in SSc, and to highlight central role of CMR in its detection, offering a comprehensive description of the imaging features and their prognostic implication.
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spelling doaj-art-ed31434ca5a54762a2d6e3f55fb3ec122025-08-20T03:41:40ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-08-011210.3389/fmed.2025.16065931606593Cardiac magnetic resonance in systemic sclerosis: imaging features and potential prognostic implications. A literature reviewGiovanni Vitale0Matteo Colina1Domenico Attinà2Fabio Niro3Paolo Ortolani4Cardiology Unit, Ospedale Santa Maria della Scaletta, Imola, ItalyService of Rheumatology, Section of Internal Medicine, Department of Medicine and Oncology, Ospedale Santa Maria della Scaletta, Imola, ItalyDepartment of Pediatric and Adult Cardio-Thoracovascular, Oncohematologic and Emergencies Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDepartment of Pediatric and Adult Cardio-Thoracovascular, Oncohematologic and Emergencies Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyCardiology Unit, Ospedale Santa Maria della Scaletta, Imola, ItalySystemic sclerosis (SSc) is a chronic, multisystem disorder characterized by vascular dysfunction, immune dysregulation with production of autoantibodies, fibroblasts dysfunction and consequent abnormal collagen production, leading to progressive fibrosis of the skin and various organs. Cardiac involvement is common, affecting the myocardium, pericardium, valvular structures and conduction tissue, even though it is often unrecognized. Despite this, it is a major determinant of morbidity and mortality in SSc, being responsible for about 15% of all deaths. Due to the relevant prognostic implications of cardiac involvement its early detection is mandatory. A comprehensive screening through a multimodality approach is required in all patients with SSc, even in those without overt cardiac symptoms. Cardiac magnetic resonance (CMR) is now considered the gold standard for non-invasive detection of the myocardial disease SSc related. It provides not only a morphological and functional assessment, but also offers an ultrastructural definition of the myocardium, particularly by the detection of fibrosis and myocardial inflammation (MI), unmasking an initial myocardial involvement since the early stage of disease. The aim of this review is to describe the potential spectrum of cardiac involvement in SSc, and to highlight central role of CMR in its detection, offering a comprehensive description of the imaging features and their prognostic implication.https://www.frontiersin.org/articles/10.3389/fmed.2025.1606593/fullcardiac magnetic resonancefibrosissystemic sclerosispulmonary arterial hypertensionprognostic factorsmyocardial inflammation
spellingShingle Giovanni Vitale
Matteo Colina
Domenico Attinà
Fabio Niro
Paolo Ortolani
Cardiac magnetic resonance in systemic sclerosis: imaging features and potential prognostic implications. A literature review
Frontiers in Medicine
cardiac magnetic resonance
fibrosis
systemic sclerosis
pulmonary arterial hypertension
prognostic factors
myocardial inflammation
title Cardiac magnetic resonance in systemic sclerosis: imaging features and potential prognostic implications. A literature review
title_full Cardiac magnetic resonance in systemic sclerosis: imaging features and potential prognostic implications. A literature review
title_fullStr Cardiac magnetic resonance in systemic sclerosis: imaging features and potential prognostic implications. A literature review
title_full_unstemmed Cardiac magnetic resonance in systemic sclerosis: imaging features and potential prognostic implications. A literature review
title_short Cardiac magnetic resonance in systemic sclerosis: imaging features and potential prognostic implications. A literature review
title_sort cardiac magnetic resonance in systemic sclerosis imaging features and potential prognostic implications a literature review
topic cardiac magnetic resonance
fibrosis
systemic sclerosis
pulmonary arterial hypertension
prognostic factors
myocardial inflammation
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1606593/full
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