Figure 3. Clinical algorithm for screening and diagnosis of cardiac involvement in systemic sclerosis.
BNP, B-type natriuretic peptide; CAD, coronary artery disease; CMR, cardiac magnetic resonance; CPET, cardiopulmonary exercise testing; DLCO, carbon monoxide diffusing capacity; ILD, interstitial lung disease; JVP, jugular venous pulsations; LVEF, left ventricular ejection fraction; NT-proBNP, N-terminal pro-B-type natriuretic peptide; PA, pulmonary artery; PAH, pulmonary arterial hypertension; RV, right ventricle; TAPSE, tricuspid annular plane systolic excursion. *Differential diagnosis also includes noncardiac causes of natriuretic peptide evaluation including renal insufficiency, sepsis/critical illness, glucocorticoids, malignancy, and weight loss/cachexia.