Abstract
Background. Interstitial lung disease (ILD) is one of the most frequent and life-threatening manifestations of systemic sclerosis (SSc), significantly worsening the prognosis and quality of life of patients. Identification of risk factors for its development, particularly serological and microcirculatory alterations, is crucial for optimizing patient management and preventing progression of pulmonary fibrosis. Aim: to identify potential risk factors for ILD development in patients with SSc and to evaluate its association with clinical, laboratory, and instrumental features of the disease. Materials and methods. Data from 41 patients with SSc were analyzed. Depending on the presence of ILD according to multislice computed tomography (MSCT) of the chest, patients were divided into two groups. The assessment included forced vital capacity (FVC), diffusing capacity for carbon monoxide (DLCO), nailfold videocapillaroscopy, echocardiography, serological profile, and the degree of skin involvement evaluated using the modified Rodnan skin score (mRSS). Statistical analysis was performed using Jamovi 2.3.28.0. Results. ILD was significantly associated with the diffuse form of SSc (96.2% vs. 26.7%; p<0.001), higher mRSS values (22.9 vs. 15.5; p=0.007), anti-Scl-70 positivity (57.7% vs. 19.2%; p=0.024), lower FVC (74.9% vs. 96.5%; p=0.010), and a reduced E/A ratio <0.8, indicating early signs of left ventricular diastolic dysfunction (57.7% vs. 20.0%; p=0.025). Patients with ILD more frequently demonstrated active and late capillaroscopic patterns (41.2% and 58.8%, respectively), accompanied by decreased capillary density (76.5% vs. 27.3%; p=0.033). In addition, digital ulcers were observed more often in this group (69.2% vs. 33.3%; p=0.049). Conclusion. The presence of ILD in SSc is significantly associated with several unfavorable clinical and instrumental features, including the diffuse disease subtype, more severe skin fibrosis, reduced FVC and DLCO, decreased E/A ratio <0.8 as a potential marker of diastolic dysfunction, as well as active/late capillaroscopic patterns and higher prevalence of digital ulcers. These findings emphasize the importance of early comprehensive diagnostics, risk stratification, and a personalized approach to the management of patients with SSc