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Cardiovascular disease in systemic sclerosis

Francesca Cannarile1, Valentina Valentini1, Giulia Mirabelli1

  • 1Department of Medicine, Rheumatology Unit, University of Perugia, Via dal Pozzo 06132, Perugia, Italy.

Annals of Translational Medicine
|February 24, 2015
PubMed

Insights

Systemic sclerosis (SSc) patients show increased macrovascular disease and premature atherosclerosis, linked to inflammation and endothelial damage. This review examines the causes and clinical impact of these cardiovascular complications in SSc.

Area of Science:

  • Rheumatology
  • Cardiology
  • Immunology

Background:

  • Cardiovascular system involvement is common in autoimmune diseases like systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).
  • While microvascular disease is characteristic of systemic sclerosis (SSc), recent studies indicate a higher prevalence of macrovascular disease in SSc patients compared to controls.
  • This macrovascular disease in SSc is associated with a poorer prognosis.

Purpose of the Study:

  • To analyze the causes of macrovascular involvement and premature atherosclerosis (ATS) in systemic sclerosis (SSc).
  • To describe the clinical manifestations of macrovascular disease and ATS in SSc patients.
  • To review the current understanding of mechanisms underlying ATS in SSc.

Main Methods:

  • Literature review of studies investigating cardiovascular complications in systemic sclerosis (SSc).
  • Analysis of research on the prevalence and mechanisms of macrovascular disease and atherosclerosis in SSc.
  • Synthesis of data on endothelial dysfunction, inflammation, and vascular repair in SSc-related ATS.

Main Results:

  • Systemic sclerosis (SSc) is associated with a higher prevalence of macrovascular disease and premature atherosclerosis (ATS) compared to the general population.
  • Mechanisms contributing to ATS in SSc include multi-system organ inflammation, endothelial damage, vasculopathy, and impaired vascular repair.
  • Endothelial cell injury, ischemia/reperfusion, immune-mediated cytotoxicity, and defective vasculogenesis play key roles in vascular injury in SSc.

Conclusions:

  • Macrovascular disease and premature atherosclerosis are significant concerns in systemic sclerosis (SSc) patients.
  • Understanding the complex interplay of inflammation, endothelial dysfunction, and immune mechanisms is crucial for managing cardiovascular risk in SSc.
  • Further research is needed to elucidate the precise pathways and develop targeted therapies for ATS in SSc.

Keywords:
Atherosclerosis (ATS)cardiovascular (CV) diseasesystemic sclerosis (SSc)

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