Echocardiographic Evaluation of Global Cardiac Function in Systemic Sclerosis‐Associated Pulmonary Arterial Hypertension: An Integrated Review of Parameters and Techniques

Systemic sclerosis (SSc) is a connective tissue disease frequently complicated by pulmonary arterial hypertension (PAH), a leading cause of morbidity and mortality. Global cardiac function is a key determinant of prognosis and treatment response in SSc-PAH, necessitating precise and dynamic assessment. Echocardiography provides a comprehensive, noninvasive modality for this purpose. This narrative review synthesizes recent advances in echocardiographic evaluation of global cardiac function in SSc-PAH. It covers established parameters of right and left ventricular function, emerging indices such as the TAPSE/sPAP ratio and atrial strain, and the role of advanced techniques including stress echocardiography and speckle-tracking imaging. The integration of these approaches enhances early detection, risk stratification, and therapeutic monitoring. Future directions, including three-dimensional echocardiography and artificial intelligence, are highlighted for their potential to refine a comprehensive, ultrasound-based assessment framework for SSc-PAH.