Factors associated with pericardial effusion development and persistence in systemic sclerosis: a single-centre retrospective analysis

Heart involvement in Systemic Sclerosis (SSc) remains among the leading causes of disease-related deaths. SSc has been associated with an increased risk of pericardial effusion (PerEff). The aim of our study was to examine the prevalence and identify possible factors associated with ever and persistent SSc-PerEff. For this retrospective study, consecutive patients with a diagnosis of SSc, that visited our Outpatient Unit until June 2024, were recruited. Demographic data, disease manifestations, serological profile, and internal organ involvement were collected. Initially, participants with at least one measurement of PerEff were enrolled. For the second step individuals with at least two echocardiograms were included and were classified into three groups: single, persistent and never PerEff. In total 290 adult patients (female-to-male ratio 5.6:1) were included. Results showed that 24.5% of the patients had at least one echocardiogram ever positive for PerEff and 13.2% exhibited persistent PerEff. In the multivariate analysis, ever PerEff was associated with the presence of pulmonary hypertension [PH, Odds ratio, (OR):3.22, p < 0.01], interstitial lung disease (ILD, OR:4.18, p < 0.01), telangiectasias (OR:4.25, p < 0.01) and elevated erythrocyte sedimentation rate (ESR, OR:2.01, p < 0.05). Persistent PerEff was, also, associated with PH (OR:2.90, p < 0.05), ILD (OR:6.65, p < 0.05), telangiectasias (OR:4.84, P < 0.05) and elevated ESR (OR:2.76, p < 0.05). PerEff is a common disease-related manifestation. Both ever and persistent PerEff were associated with PH, ILD, telangiectasias and increased inflammatory markers. The present study further supports the clinical significance of PerEff in SSc patients, with important implications in disease course and management.