Uncovering Subclinical Cardiac Involvement in Vedoss: An Echocardiographic Driven Study

Background: The 2011 Very Early Diagnosis of Systemic Sclerosis (VEDOSS) criteria include patients at risk of progression and those with mild, non-progressive forms of SSc. Early diastolic and systolic dysfunction can indicate myocardial fibrosis in SSc patients, yet data on myocardial impairment in the VEDOSS population are limited. Objectives: This study aimed to identify subclinical echocardiographic changes and predictive markers of cardiac dysfunction in both very early and mild-longstanding forms of VEDOSS. Methods: We conducted a cross-sectional ob-servational study involving 81 patients meeting VEDOSS criteria followed up regular-ly within our Scleroderma referral center. Patients were categorized as early VEDOSS (e-VEDOSS) or mild-longstanding VEDOSS (ml-VEDOSS) based on disease duration (≥10 years). We analyzed clinical and demographic data, focusing on echocardio-graphic parameters such as the E/A ratio and left ventricular (LV) thickness. Statistical analyses included Chi-square, Fischer exact, and Student's T tests, with a significance threshold of p<0.05. Results: ml-VEDOSS patients were older and had longer diagnostic delays, with a higher burden of comorbidities. Autoantibody-positive patients exhibited lower E/A ratios and increased left atrial size. Notably, patients with reduced E/A ratios were older, had more comorbidities, and lower DLCO% values. Multivariable analysis confirmed DLCO% as the sole predictor of both diastolic and systolic impairment in both groups. Conclusion: Careful Monitoring of cardiac function in VEDOSS patients is crucial as subclinical alterations may occur even in the absence of symptoms. DLCO% emerged as an important predictor of diastolic dysfunction.