Vascular endothelial injury assessed with functional techniques in systemic sclerosis patients with pulmonary arterial hypertension versus systemic sclerosis patients without pulmonary arterial hypertension: a systematic review and meta-analysis

Theodorakopoulou, Marieta; Minopoulou, Ioanna; Sarafidis, Pantelis; Kamperidis, Vasileios; Papadopoulos, Christodoulos; Dimitroulas, Theodoros; Boutou, Afroditi

doi:10.1007/s00296-021-04850-2

Cited by 10 publications

(47 citation statements)

References 27 publications

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“…An imbalance occurs between the mediators which control vasomotor tone that leads irreversible remodeling of the pulmonary vessels as a result of vasoconstriction, vascular endothelial cell proliferation, vascular smooth muscle hypertrophy during PAH progression. [3]. Remodeling of the pulmonary vessels causes impairment in pulmonary elasticity [18].…”

Section: Discussionmentioning

confidence: 99%

“…Skin and many other organ involvements can occur [2]. Although SSc is a rare disease, it is associated with higher morbidity and early mortality than other rheumatological diseases as a result of developing SSc-associated interstitial pulmonary disease (ILD) and/or pulmonary arterial hypertension (PAH) [3,4]. In Western countries, PAH associated with connective tissue disease (CTD) is in second place after idiopathic PAH for etiology of PH.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of pulmonary arterial stiffness in patients with systemic sclerosis without overt pulmonary hypertension

Çoksevim

Çerik²,

Yenerçağ³

et al. 2022

Int J Cardiovasc Imaging

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Pulmonary hypertension (PH) is a pathophysiological disorder that may involve multiple clinical conditions and complicate most systemic diseases. Systemic Sclerosis (SSc), represents the leading cause of connective tissue disease (CTD) associated with PAH. Although SSc is a rare disease, it is associated with higher morbidity and early mortality than other rheumatological diseases due to developing SSc-associated interstitial pulmonary disease (ILD) and/or pulmonary arterial hypertension (PAH). The impact of the early diagnosis on the prognosis is evident. In this context, in our study, we aimed to investigate the early changes in pulmonary vascular bed by measuring pulmonary arterial stiffness (PAS) in SSc patients without overt PAH. Sixty-two SSc patients and fty-eight gender and agematched, healthy subjects enrolled in this cross-sectional observational study. SSc patients were evaluated in terms of disease duration and severity. Modi ed Rodnan skin score (mRSS) was calculated as disease severity index. Echocardiographic parameters were assessed and compared to the control group. Right Ventricular (RV) diameters, systolic pulmonary artery pressure (sPAP), and right ventricle myocardial performance index (RV-MPI) were signi cantly higher in the SSc group compared to the control group (p < 0.05). Tricuspid annular plane systolic excursion (TAPSE) and right ventricular fractional area change (RV-FAC) were signi cantly lower in the SSc group compared to the control group (p < 0.05). PAS value (25.5 ± 9.2 kHz/ms vs. 18.1 ± 7.4 kHz/ms, p <0.001) was signi cantly higher in the SSc group than in the control group. A statistically signi cant positive correlation relationship was detected between the PAS value and CRP, ESR, disease duration, mRSS. According to these results, in SSc patients, PAS as an inexpensive and easily applicable echocardiographic method might serve as a marker of early detection of PAH.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of pulmonary arterial stiffness in patients with systemic sclerosis without overt pulmonary hypertension

Çoksevim

Çerik²,

Yenerçağ³

et al. 2022

Int J Cardiovasc Imaging

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“…In the last years, methodologies that allow functional microcirculation assessment have been used, including established methods based on medium vessels, such as flowmediated vasodilatation (FMD) of brachial artery (160), or small digital vessels, namely peripheral arterial tonometry (PAT) (161), as well as laser doppler techniques, such as laser doppler flowmetry (LDF), laser doppler imaging (LDI) (162), laser speckle contrast imaging (LSCI), laser speckle contrast analysis (LASCA), and near-infrared spectroscopy (NIRS) (163). All of these techniques found a common basic principle: a vasodilatation in healthy arteries in response to mechanical (e.g., post-occlusive reactive hyperemia), physical (e.g., thermal challenges) and chemical stimuli (e.g., pharmacological with vasoactive substances, administered through intra-arterial infusion or iontophoresis) (138,156).…”

Section: Other Techniquesmentioning

confidence: 99%

“…LDI works as LDF but enables the evaluation of blood flow over a larger area of the skin compared to LDF. LSCI measures the fluctuating granular pattern produced by the reflection of the moving red blood cells illuminated by laser lights (162).…”

Section: Other Techniquesmentioning

confidence: 99%

Endothelial Dysfunction in Systemic Lupus Erythematosus and Systemic Sclerosis: A Common Trigger for Different Microvascular Diseases

et al. 2022

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This review describes the complex interplay between inflammation, vasculopathy and fibrosis that involve the heart and peripheral small vessels, leading to endothelial stiffness, vascular damage, and early aging in patients with systemic lupus erythematosus and systemic sclerosis, which represents two different models of vascular dysfunction among systemic autoimmune diseases. In fact, despite the fact that diagnostic methods and therapies have been significantly improved in the last years, affected patients show an excess of cardiovascular mortality if compared with the general population. In addition, we provide a complete overview on the new techniques which are used for the evaluation of endothelial dysfunction in a preclinical phase, which could represent a new approach in the assessment of cardiovascular risk in these patients.

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“…I read the interesting study evaluating "Assessment of Pulmonary Arterial Stiffness in Patients with Systemic Sclerosis without Overt Pulmonary Hypertension" by Coksevim et al It is very well known that the development of pulmonary hypertension noticeably increases morbidity and mortality in all conditions [1]. Considering the incidence of pulmonary hypertension associated with connective tissue diseases (CTD), especially in patients with systemic sclerosis, the impact of early diagnosis and treatment on prognosis in this patient group is obvious [2].…”

Section: Editorial Commentarymentioning

confidence: 99%

Demonstration of subclinical involvement with pulmonary arterial stiffness in patients with systemic sclerosis without overt pulmonary hypertension

Doğduş

2022

Int J Cardiovasc Imaging

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Vascular endothelial injury assessed with functional techniques in systemic sclerosis patients with pulmonary arterial hypertension versus systemic sclerosis patients without pulmonary arterial hypertension: a systematic review and meta-analysis

Cited by 10 publications

References 27 publications

Assessment of pulmonary arterial stiffness in patients with systemic sclerosis without overt pulmonary hypertension

Assessment of pulmonary arterial stiffness in patients with systemic sclerosis without overt pulmonary hypertension

Endothelial Dysfunction in Systemic Lupus Erythematosus and Systemic Sclerosis: A Common Trigger for Different Microvascular Diseases

Demonstration of subclinical involvement with pulmonary arterial stiffness in patients with systemic sclerosis without overt pulmonary hypertension

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