Cardiac Structure and Myocardial Deformation in Inflammatory Rheumatic Diseases: A Cross-Sectional Comparative Study

Background/Objectives: Cardiovascular involvement may remain clinically silent in inflammatory rheumatic diseases (IRDs), and few studies have compared cardiac structure and myocardial deformation across major IRDs using one echocardiographic protocol. We compared four IRDs and explored associations with clinical, biological, and disease-activity variables. Methods: In this single-center, cross-sectional study, 116 consecutive patients with rheumatoid arthritis (RA, n = 48), systemic lupus erythematosus (SLE, n = 26), systemic sclerosis (SSc, n = 25), and psoriatic arthritis (PsA, n = 17) underwent clinical, laboratory, electrocardiographic, and comprehensive echocardiographic assessment, including left ventricular global longitudinal strain (LV GLS) and left atrial strain. Between-group comparisons used Kruskal–Wallis and χ2/Fisher tests, and associations were tested with Spearman correlation, with Benjamini–Hochberg false discovery rate (FDR) correction. Results: After FDR correction, no echocardiographic parameter differed between groups (systolic pulmonary artery pressure, sPAP: raw p = 0.010, FDR p = 0.224); in a covariate-adjusted sensitivity analysis, only sPAP differed, being higher in SSc. LVEF was low-normal (median 50%, IQR 49–53), and LV GLS was normal (<−18%) in 99/116 patients. Of 176 whole-cohort correlations, only one survived FDR correction. In exploratory subgroup analyses, mRSS correlated with LV GLS in SSc (ρ = −0.619, p = 0.001) and DAS28 inversely with LA reservoir strain in RA (ρ = −0.428, p = 0.002). Conclusions: No between-group echocardiographic differences persisted after correction for multiple comparisons. The disease-activity–strain associations are exploratory and require confirmation before any clinical use.