Predictors of cardiac complications in systemic sclerosis

Findings of a recent cohort-based study published in Scientific reports observed that circulating biomarkers such as angiopoietin 2 (ANGPT2), osteopontin (OPN) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) were associated with cardiac complications in patients with systemic sclerosis patients.

The prospective study included a cohort of 371 systemic sclerosis patients who had undergone treatment at Oslo University Hospital’s rheumatology department and 100 healthy controls. They were compared to two custom-made candidate marker panels encompassing  molecules considered to be significant for cardiopulmonary and/or fibrotic disorders. Protocol echocardiography was used to measure left (LV) and right ventricular (RV) dysfunction three years after the serum sampling.

The researchers discovered a link between LV diastolic dysfunction and the TRAIL (OR 0.41, P = 0.007). ANGPT2 (OR 3.42, P=0.003) and OPN (OR 1.95, P = 0.026) were found to be linked to LV systolic dysfunction, as measured by global longitudinal strain. RV systolic dysfunction was linked to markers of LV dysfunction (ANGPT2, OPN, and TRAIL) (OR 1.67, P = 0.014, OR 1.86, P = 0.002, and OR 0.32, P = 0.002, respectively) and endostatin (OR 1.86, P = 0.004).

Anders and co-authors have concluded that ANGPT2, endostatin, OPN, and TRAIL are strong independent predictors of mortality in systemic sclerosis patients with cardiac dysfunction when combined with recognized risk factors for  mortality.  Further exploration of these markers could help shed light on the poorly understood pathomechanisms of cardiac systemic sclerosis, as well as developing customized  diagnosis and treatment strategies.

Reference: Tennøe AH, Murbræch K, Didriksen H, et al. Serum markers of cardiac complications in a systemic sclerosis cohort. Sci Rep. 2022 Mar 18;12(1):4661.