The burden and measurement of cardiovascular disease in SSc

Area of Science:

• Cardiology
• Rheumatology
• Vascular Medicine

Background:

• Systemic sclerosis (SSc) prognosis has improved, with declining renal crisis deaths.
• Pulmonary issues remain primary causes of mortality, but cardiovascular disease (CVD) is emerging as a significant long-term concern.
• Ischemia-reperfusion injury and endothelial dysfunction are key SSc features, potentially leading to microvascular disease and atherosclerosis.

Purpose of the Study:

• To highlight the growing role of cardiovascular disease in systemic sclerosis (SSc) prognosis.
• To emphasize the importance of detecting endothelial dysfunction, microvascular disturbances, and atherosclerosis in SSc patients.
• To recommend noninvasive techniques for assessing cardiovascular risk in SSc.

Main Methods:

• Utilizing noninvasive techniques to evaluate endothelial function, such as flow-mediated dilatation and arterial pulse wave analysis.
• Assessing microvascular blood flow to measure microcirculation.
• Measuring carotid intima-media thickness and left ventricular hypertrophy to detect atherosclerosis.

Main Results:

• Noninvasive methods can detect key cardiovascular abnormalities in SSc.
• These techniques identify endothelial dysfunction, microvascular flow disturbances, and atherosclerosis.
• Early detection facilitates targeted therapeutic strategies.

Conclusions:

• Cardiovascular disease is a critical factor in the long-term prognosis of systemic sclerosis (SSc).
• Noninvasive assessments of endothelial function and atherosclerosis are recommended for SSc management.
• Integrating these measurements can guide therapeutic interventions to mitigate cardiovascular burden in SSc patients.