This prospective cohort study evaluated whether baseline GI symptoms predict future cardiac manifestations (conduction defects, systolic dysfunction) in 459 early SSc patients (median follow-up 4.1 years) using Cox and multivariable logistic regression.
26% of patients developed cardiac manifestations during follow-up; malabsorption was the strongest predictor (HR 10.01, 95% CI 3.7–26.9). Upper GI symptoms (dysphagia, peptic ulcers) were linked specifically to conduction defects, while malabsorption was linked to systolic dysfunction.
Single cohort source may limit generalizability; GI involvement was symptom-defined without standardized objective testing; median follow-up of 4.1 years may miss later-onset cardiac events.
In early SSc, screen carefully for GI symptoms — especially malabsorption and bloating — as they may flag patients at elevated risk for cardiac involvement. Consider integrating GI findings into routine cardiac risk stratification for SSc patients.
