A longitudinal study of ankle brachial pressure indices in a cohort of patients with systemic sclerosis

Wig, Surabhi; Moore, Tonia; Manning, Joanne; Chevance, Astrid; Vail, Andy; Herrick, Ariane L.

doi:10.1093/rheumatology/keu227

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…Lower limb large vessel disease is well-recognised, in particular in patients with limited cutaneous SSc and positive anticentromere antibody, and can result in severe ischaemic complications including gangrene. 37,38 Irrespective of the underlying cause, DUs can result in significant irreversible tissue loss ( Figure 3).…”

Section: Pathophysiologymentioning

confidence: 99%

“…72 Doppler ultrasound is a relatively simple, non-invasive and reproducible test; however, it does require specialist training to make the necessary measurements. 38,72 The ankle brachial pressure index is an example of Doppler ultrasound and is calculated by the ratio of the systolic blood pressure in the upper and lower limbs, which can indicate the presence of significant lower limb ischaemia. 72 Abnormal colour and power Doppler sonography of the hand have been reported to be associated with past and new DUs in patients with SSc.…”

Section: Doppler Ultrasoundmentioning

confidence: 99%

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Raynaud phenomenon and digital ulcers in systemic sclerosis

et al. 2020

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Raynaud's phenomenon (RP) is a symptom complex related to impaired digital perfusion and can occur as a primary phenomenon or secondary to a wide range of underlying causes. RP occurs in virtually all patients with systemic sclerosis (SSc) and is often the earliest clinical manifestation in the natural history of the disease. Careful assessment is required in RP patients to avoid missing secondary causes of RP, including SSc. Digital ulcers (DUs) are a painful and disabling visible manifestation of the digital vascular injury. Significant progress has been made in the definition and assessment of DUs and understanding ulcer pathogenesis. There are a wide range of available treatments to both prevent and heal DUs; some of which are also used in RP management. The present review shall consider the assessment of patients with RP, including 'red flags' suggestive of SSc. We shall review the pathogenesis, definition and classification across the spectrum of SSc-DU disease, alongside a review on management approaches including drug therapies and surgery for SSc-RP and ulcers. We also highlight unmet needs and research priorities in SSc-RP and SSc-DUs and introduce the concept of a unified vascular phenotype in which vascular therapies may support disease modification strategies.

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Section: Pathophysiologymentioning

confidence: 99%

Section: Doppler Ultrasoundmentioning

confidence: 99%

Raynaud phenomenon and digital ulcers in systemic sclerosis

et al. 2020

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“…When comparing the subsets of SSc, dcSSc may rather tend to have altered ABPI than lcSSc [143]. ABPI values remain stable in most SSc patients over time [186].…”

Section: Ankle Brachial Pressure Index In Sscmentioning

confidence: 97%

Atherosclerosis and Cardiovascular Risk in Systemic Sclerosis

Oreská¹,

Tomčík²

2017

Systemic Sclerosis

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Atherosclerosis (ATS) has been considered to be a degenerative disease affecting large and medium-sized arteries, resulting in a passive build-up of cholesterol in the artery wall. In the last decade, immune system was proved to play the key role in the pathogenesis of ATS, suggesting ATS to be more progressive and accelerated in chronic inflammatory conditions. Studies in patients with autoimmune diseases, particularly in the most prevalent ones such as rheumatoid arthritis and systemic lupus erythematosus, confirmed the significantly more serious atherosclerotic disease and increased cardiovascular (CV) risk compared to the general population, suggesting these diseases as an independent risk factor for CV diseases. There are only few studies evaluating ATS and CV risk in systemic sclerosis (SSc). Moreover, these studies present contradictory results. Furthermore, it is complicated to differentiate primary vascular affection related to the pathogenesis of SSc from the secondary vascular infliction due to ATS. Nevertheless, most of the studies to date suggest ATS and its clinical manifestations to be more prevalent in SSc. Future studies evaluating larger cohorts of patients are required to determine the relevance of ATS and CV disease and management of these comorbidities in SSc.

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