Key result
Primary Sjögren syndrome is linked to higher myocardial T2 mapping values and lower LVEF.
Why the study?
Cardiac involvement in primary Sjögren Syndrome is often subclinical and underdiagnosed, necessitating characterization of cardiac alterations and their association with disease activity.
Does primary Sjögren Syndrome cause subclinical myocardial dysfunction and edema detectable by CMR in asymptomatic patients compared to healthy controls?
Case-Control (n=122)
No
Does primary Sjögren Syndrome cause subclinical myocardial dysfunction and edema detectable by CMR in asymptomatic patients compared to healthy controls?
Absolute Event Rate: 42.4% vs 40.5%
p-value: p=<0.001
Asymptomatic primary Sjögren Syndrome patients exhibit subclinical myocardial dysfunction and edema detectable by CMR, with severity correlating with disease activity and markers like elevated rheumatoid factor.
CMR-detected subclinical changes in asymptomatic pSS may signal early involvement; hypothesis-generating and requires prospective validation before any screening role.
Cardiac involvement in primary Sjögren Syndrome (pSS) is often subclinical and underdiagnosed. This study aimed to characterize cardiac alterations in asymptomatic pSS patients using cardiac magnetic resonance (CMR) and to investigate their association with disease activity. In this retrospective study, 71 pSS patients (categorized by ESSDAI into low, moderate, and high disease activity groups) and 51 matched controls underwent 3.0T CMR. Assessments included left ventricular (LV) function parameters (ejection fraction [LVEF], global longitudinal, circumferential, and radial strain [GLS, GCS, GRS]) and myocardial tissue characteristics (native T1, T2). Statistical analyses compared groups and evaluated correlations between CMR parameters, ESSDAI scores, and clinical/laboratory markers. Compared to controls, pSS patients exhibited significantly lower LVEF (61% vs. 64%, P = 0.016), reduced GLS (-16% vs. -18%, P < 0.001), elevated global T2 (42.4 vs. 40.5 ms, P < 0.001) and native T1 (1215.0 vs. 1193.0 ms, P = 0.027) values. These abnormalities were most pronounced in the high-activity group. ESSDAI scores showed a moderate negative correlation with GRS ( r =-0.302, P = 0.010) and a weak positive correlation with GCS ( r = 0.288, P = 0.015). Univariable and multivariable analysis identified rheumatoid factor (RF) > 20 IU/mL (β=-3.79, P = 0.016) as an independent factor associated with decreased LVEF. While presence of Raynaud phenomenon (β = 2.04, P = 0.013) was independently associated with increased T2 values. Asymptomatic pSS patients exhibited subclinical myocardial dysfunction and edema detectable by CMR, with severity correlating with disease activity. Elevated RF and presence of Raynaud phenomenon were independently associated with cardiac involvement, suggesting that CMR may be warranted for early cardiac evaluation in pSS patients, particularly those with these risk indicators.
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Liu et al. (2026) conducted a case-control in Primary Sjögren Syndrome (n=122). Primary Sjögren Syndrome vs. Matched controls was evaluated on Global T2 mapping value (ms) (p=<0.001). Asymptomatic primary Sjögren Syndrome patients exhibited significantly lower LVEF (61% vs. 64%) and elevated global T2 mapping (42.4 vs. 40.5 ms) compared to matched controls.
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