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The post-occlusive hyperemic response in patients with systemic sclerosis
F M Wigley1, R A Wise, J Mikdashi
1Department of Medicine, Johns Hopkins University School of Medicine, Francis Scott Key Medical Center, Baltimore, Maryland.
Arthritis and Rheumatism
|November 1, 1990
Summary
Patients with systemic sclerosis (SSc) show impaired skin blood flow due to structural damage, unlike those with primary Raynaud's phenomenon. Carboprostacyclin did not improve blood flow in SSc patients, indicating fixed vascular defects.
Area of Science:
- Vascular Biology
- Dermatology
- Rheumatology
Background:
- Raynaud's phenomenon involves episodic digital ischemia.
- Systemic sclerosis (SSc) can cause secondary Raynaud's phenomenon.
- Understanding microvascular dysfunction in SSc is crucial.
Purpose of the Study:
- To compare post-ischemic reactive hyperemia in primary Raynaud's phenomenon and SSc.
- To investigate the effect of carboprostacyclin on microvascular blood flow in SSc.
Main Methods:
- Laser Doppler flowmetry used to measure cutaneous blood flow.
- Reactive hyperemia assessed after suprasystolic occlusion.
- Carboprostacyclin infusion administered to SSc patients.
Main Results:
- Primary Raynaud's phenomenon patients exhibited normal reactive hyperemia.
- SSc patients displayed reduced baseline and peak blood flow.
- Carboprostacyclin failed to improve blood flow or reactive hyperemia in SSc patients.
Conclusions:
- SSc-related microvascular impairment may stem from fixed structural defects.
- Vasodilator therapy may be ineffective in SSc due to underlying structural changes.
- Distinguishing between primary Raynaud's and SSc is important for prognosis.