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dc.contributor.authorTennøe, Anders
dc.contributor.authorMurbræch, Klaus
dc.contributor.authorAndreassen, Johanna
dc.contributor.authorFretheim, Håvard Halland
dc.contributor.authorGaren, Torhild Oddveig
dc.contributor.authorGude, Einar
dc.contributor.authorAndreassen, Arne K.
dc.contributor.authorAakhus, Svend
dc.contributor.authorMolberg, Øyvind
dc.contributor.authorHoffmann-Vold, Anna-Maria
dc.identifier.citationJournal of the American College of Cardiology. 2018, 72 (15), 1804-1813.nb_NO
dc.description.abstractBackground Primary cardiac affection is common and is a major cause of death in systemic sclerosis (SSc), but there are knowledge gaps regarding the effect of cardiac dysfunction on mortality. Objectives The purpose of this study was to evaluate diastolic function in a large, unselected SSc cohort and assess the effect of diastolic dysfunction (DD) on mortality. Methods SSc patients followed prospectively at the Oslo University Hospital from 2003 to 2016 with available echocardiographies and matched control subjects were included. DD was assessed by echocardiography according to the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines. Pulmonary hypertension (PH) was diagnosed by right heart catheterization. Vital status was available for all patients. Cox regression analyses with hazards ratios (HRs) were conducted. Results Diastolic function was assessed in 275 SSc patients at baseline and in 186 patients at follow-up. At baseline, 46 of the 275 SSc patients (17%) were diagnosed with DD and 195 (71%) had normal diastolic function. After a median follow-up of 3.4 years (interquartile range: 1.6 to 6.2 years), the proportion of DD increased from 17% to 29%. During follow-up, 57% of patients with DD at baseline died, compared with 13% of patients with normal diastolic function. At baseline, 86 patients had performed right heart catheterization, and 43 were diagnosed with PH; of these 60% deceased. In multivariable Cox regression analyses, DD was a stronger predictor of death (HR: 3.7; 95% CI: 1.69 to 8.14; c-index 0.89) than PH (HR: 2.0; 95% CI: 1.1 to 3.9; c-index 0.84). Conclusions DD is frequent in SSc, and the presence of DD is associated with high mortality. DD exceeds PH with respect to predicting mortality.nb_NO
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internasjonal*
dc.titleLeft ventricular diastolic dysfunction predicts mortality in patients with systemic sclerosisnb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.source.journalJournal of the American College of Cardiologynb_NO
dc.description.localcode© 2018. This is the authors’ accepted and refereed manuscript to the article. Locked until 1.10.2020 due to copyright restrictions. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
cristin.unitnameInstitutt for sirkulasjon og bildediagnostikk

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Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal