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Micro- and macrovascular treatment targets in scleroderma heart disease

Theodoros Dimitroulas, George Giannakoulas, Haralambos Karvounis

  • 1Department of Rheumatology, Dudley Group NHS FT, Russells Hall Hospital, Dudley, DY1 2HQ, UK. dimitroul@hotmail.com.

Current Pharmaceutical Design
|April 10, 2013
PubMed

Insights

Systemic sclerosis (SSc) often involves the heart, causing myocardial fibrosis and heart failure. Early detection and vasodilators can improve cardiac function and prevent disease progression in SSc patients.

Area of Science:

  • Cardiology
  • Rheumatology
  • Internal Medicine

Background:

  • Cardiac involvement is a frequent and prognostically significant complication of systemic sclerosis (SSc).
  • Myocardial fibrosis, leading to arrhythmias and heart failure, is the hallmark.
  • Subclinical cardiac disease is common, with overt symptoms indicating a poor prognosis.

Purpose of the Study:

  • To review the pathophysiology, diagnosis, and management of cardiac involvement in SSc.
  • To clarify the role of microvascular dysfunction versus atherosclerotic coronary artery disease in SSc.
  • To discuss current and future therapeutic strategies for SSc-related heart disease.

Main Methods:

  • Review of existing literature on cardiac manifestations in SSc.
  • Analysis of pathophysiological mechanisms, including myocardial fibrosis and coronary abnormalities.
  • Evaluation of diagnostic techniques and therapeutic interventions.

Main Results:

  • Myocardial fibrosis and microvascular dysfunction are primary mechanisms, though atherosclerotic disease prevalence is debated.
  • Vasodilators show potential in improving myocardial function and perfusion.
  • Clinically apparent cardiac disease in SSc is associated with adverse outcomes.

Conclusions:

  • Cardiac involvement significantly impacts SSc prognosis, primarily through myocardial fibrosis and microvascular dysfunction.
  • Further research is needed to elucidate the role of coronary artery disease and develop targeted therapies.
  • Early detection and management, potentially with vasodilators, are crucial for improving outcomes in SSc patients with cardiac complications.

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