Evaluation of Cardiovascular Damage in Patients with Systemic Scleroderma

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.