Evaluation of Cardiovascular Damage in Patients with Systemic Scleroderma
Keywords:
atherosclerosis, systemic scleroderma, cytokineAbstract
Systemic scleroderma (SS) is a diffuse connective tissue disease in which one of the main targets of the pathological process is the vessels of the microvasculature. Involvement of vessels of a larger caliber, including arteries of small diameter of the extremities and internal organs, is noted in many patients, but its significance has been studied much less. At the same time, the proportion of mortality in patients with SS from cardiovascular complications is steadily increasing.
Aim. To determine the frequency of detection of atherosclerosis, to clarify the nature of atherosclerotic lesions of brachiocephalic arteries in patients with systemic scleroderma (SS), to identify the main factors influencing this process.
Material and methods. 40 patients with SS were examined. The indicators of vascular stiffness in the area of the carotid artery - femoral artery, lipid spectrum, glucose, uric acid, and the concentration of cytokines in the blood serum were determined.
Results. An increase in the thickness of the intima-media complex (TIM) was recorded in 75% (n=30/40) of the examined patients with SS. Various degrees of stenosis of the arterial lumen (25- 75%) — in 50% (n=20/40) of patients. The relationship between aterosclerosis and certain classical risk factors (RF) was determined. Among non-classical risk factors, a relationship has been found between TIM and IL-6.
Conclusion. In patients with SS in the genesis of atherosclerosis, a certain proportion belongs primarily to inflammatory mediators, as well as metabolic disorders characteristic of SS (uricemia). This may indicate the existence of a special combination of pathogenetic mechanisms of arterial walldamage in patients with SS, and may qualify for a re-evaluation of the state of patients with SS, using a larger sample of patients and additional research methods.
References
Man A, Zhu Y, Zhang Y, et al. The risk of cardiovascular disease in systemic sclerosis: a populationbased cohort study. Ann Rheum Dis 2013; 72(7): 1188-93.
Muller-Ladner U, Distler O, Ibba-Manneschi L, et al. Mechanisms of vascular damage in systemic sclerosis. Autoimmunity 2009; 42(7): 587-95.
Pattanaik D, Brown M, Postlethwaite AE. Vascular involvement in systemic sclerosis (scleroderma). J Inflamm Res 2011; 4:105-25.
Pencina MJ, D'Agostino RB, Larson MG, et al. Predicting the 30-year risk of cardiovascular disease:the framingham heart study. Circulation 2009; 119(24): 3078-84.
Culleton BF, Larson MG, Kannel WB, et al. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med 1999; 131(1): 7-13.
Kim SY, Guevara JP, Kim KM, et al. Hyperuricemia and coronary heart disease: a systematic reviewand meta-analysis. Arthritis Care Res (Hoboken) 2010; 62(2): 170-80.
Aripova, N. А., et al. “The role of pro-inflammatory cytokines in various types of systemic scleroderma”. Seybold Rep. J 18.06 (2023): 1469-1476.
Elshamy HA, Ibrahim SE, Farouk HM, et al. N-terminal pro-brain natriuretic peptide in systemic sclerosis: new insights. Eur J Dermatol 2011; 21(5): 686-90.
Hu Z, Zhang J, Guan A, et al. Granulocyte colony-stimulating factor promotes atherosclerosis in highfat diet rabbits. Int J Mol Sci 2013; 14(3): 4805-16.
Ait-Oufella H, Taleb S, Mallat Z, et al. Recent advances on the role of cytokines in atherosclerosis. Arterioscler Thromb Vasc Biol 2011; 31(5): 969-79.
Colaci M, Giuggioli D, Manfredi A, et al. Aortic pulse wave velocity measurement in systemic sclerosis patients. Reumatismo 2012; 64(6): 360-7.
Constance J, Germain C, Gosse P, et al. Arterial stiffness predicts severe progression in systemic sclerosis: the ERAMS study. J Hypertens 2007; 25(9): 1900-6.
Maslyanskiy AL, Kolesova EP, Penin IN, et al. The impact of anti-B cell therapy on the rigidity of the vascular wall in patients with systemic scleroderma. arterial hypertension 2013; 19(3): 212-20. Russian
Bekenova G. T. et al. Importance of pulse-therapy in peripheral vascular damage in systemic scleroderma. – 2024.
Katsumoto TR, Whitfield ML, Connolly MK. The pathogenesis of systemic sclerosis. Annu Rev Pathol 2011; 6:509-37.
Man A, Zhu Y, Zhang Y, et al. The risk of cardiovascular disease in systemic sclerosis: a populationbased cohort study. Ann Rheum Dis 2013; 72(7): 1188-93.
