[Systemic sclerosis and macrovascular involvement: Status of the issue in 2019]

J Med Vasc. 2019 Dec;44(6):400-421. doi: 10.1016/j.jdmv.2019.09.002. Epub 2019 Sep 28.
[Article in French]

Abstract

Systemic sclerosis (SSc) is a rare immune disease leading to fibrosis of the skin and internal organs. Microvasculopathy is a hallmark of SSc. However, some patients have severe macrovascular complications as affecting cerebral, cardiac or peripheral vessels. To date, macrovascular involvement in SSc remains a matter of debate. Many studies have shown an increased prevalence of macrovascular involvement in SSc in comparison with controlled subjects with similar cardiovascular risk factors. Various methods were used: ankle brachial pressure index, intima media thickness, imagery, coronary calcium score, pulse wave velocity, or flow mediated dilation. The pathophysiology of macrovascular involvement remains unknown and is probably multifactorial: accelerated atherosclerosis, endothelial dysfunction, or reflected wave of microvessel obliteration. The aim of this study was to perform a comprehensible review of the literature, through the study of different types of involved vessels. Results of the main studies are summarized in tables according to the method of investigation used.

Keywords: Artery stiffness; Atherosclerosis; Athérosclérose; Dysfonction endothéliale; Endothelial dysfunction; Macrovasculaire; Macrovascular; Rigidité artérielle; Sclérodermie systémique; Systemic sclerosis.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Arteries / pathology
  • Arteries / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Risk Factors
  • Scleroderma, Systemic / complications*
  • Scleroderma, Systemic / diagnostic imaging
  • Scleroderma, Systemic / physiopathology
  • Scleroderma, Systemic / therapy
  • Vascular Diseases / diagnostic imaging
  • Vascular Diseases / etiology*
  • Vascular Diseases / physiopathology
  • Vascular Diseases / therapy
  • Vascular Remodeling*
  • Vascular Stiffness*