Salivary Gland Focus Score is Associated with Myocardial Fibrosis in Primary Sjögren's Syndrome Assessed by a Cardiac Magnetic Resonance Approach.

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The risk of clinically manifested major cardiovascular events in primary Sjögren's syndrome (pSS) remains unclear. This study aimed to assess myocardial fibrosis in pSS and investigate the associated disease characteristics by cardiac magnetic resonance (CMR) imaging.We performed a cross-sectional study of patients with pSS without cardiac symptoms. Labial gland biopsy was documented in 44 patients (85%). Patients without cardiovascular risk factors underwent contrast-enhanced CMR. Late gadolinium enhancement (LGE) was used to assess myocardial fibrosis. Myocardial edema was assessed using T2- weighted imaging (T2-WI). We compared the left ventricular (LV) geometry and function between the groups with and without LGE. Furthermore, we explored the associations of CMR abnormalities with pSS characteristics.Fifty-two women with pSS (median age: 55, interquartile range: 47.0-65.7 years) were enrolled in the study. LGE was observed in 10 patients (19%), two of whom showed high intensity on T2-WI. High intensity on T2-WI was observed in three patients (5.8%). LV mass index and LV mass/end-diastolic volume tended to be higher in the LGE-positive group than in the LGE-negative group (p = 0.078 and 0.093, respectively). Salivary gland focus score (FS) ≥3 was independently associated with LGE-positive in the multivariable analysis (odds ratio: 11.21, 95% confidence interval: 1.18-106.80).Subclinical myocardial fibrosis, as detected by CMR, was frequent in patients with pSS without cardiac symptoms. Abnormal CMR findings were associated with salivary gland FS ≥3.


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