Abstract
Cardiac involvement in systemic sclerosis (SSc) is a frequent visceral complication that considerably affects the prognosis of the disease. The pathophysiologic hallmark is myocardial fibrosis which can progress leading to arrhythmia, right and/or left heart dysfunction and failure. Symptoms range from unusual to prominent and from mild to dramatic, but clinically overt disease is a poor prognostic factor. Primary myocardial involvement is related to focal ischemia due to transient coronary spasm, and the available data support that microvascular functional and structural abnormalities rather than macrovascular coronary involvement represent the main underlying mechanism of the disease. However, the existence and prevalence of atherosclerotic coronary artery disease in SSc remain to be determined, as several studies have generated conflicting reports. Despite the lack of effective targeted therapy for SSc itself, sensitive and quantitative techniques have demonstrated the ability of vasodilators to improve myocardial function and perfusion and to prevent the evolution of subclinical heart involvement to decompensated heart failure. Further research will provide a better understanding of the disease by detecting the potent contribution of coronary artery involvement, explaining differences in accelerated atherosclerosis between SSc and other autoimmune disorders, and opening directions for the development of novel treatment strategies for this life-threatening complication of SSc.
Keywords: Systemic sclerosis, cardiac involvement, myocardium, small coronary artery disease, pulmonary arterial hypertension, tissue Doppler.
Current Pharmaceutical Design
Title:Micro- and Macrovascular Treatment Targets in Scleroderma Heart Disease
Volume: 20 Issue: 4
Author(s): Theodoros Dimitroulas, George Giannakoulas, Haralambos Karvounis, Alexandros Garyfallos, Lucas Settas and George D. Kitas
Affiliation:
Keywords: Systemic sclerosis, cardiac involvement, myocardium, small coronary artery disease, pulmonary arterial hypertension, tissue Doppler.
Abstract: Cardiac involvement in systemic sclerosis (SSc) is a frequent visceral complication that considerably affects the prognosis of the disease. The pathophysiologic hallmark is myocardial fibrosis which can progress leading to arrhythmia, right and/or left heart dysfunction and failure. Symptoms range from unusual to prominent and from mild to dramatic, but clinically overt disease is a poor prognostic factor. Primary myocardial involvement is related to focal ischemia due to transient coronary spasm, and the available data support that microvascular functional and structural abnormalities rather than macrovascular coronary involvement represent the main underlying mechanism of the disease. However, the existence and prevalence of atherosclerotic coronary artery disease in SSc remain to be determined, as several studies have generated conflicting reports. Despite the lack of effective targeted therapy for SSc itself, sensitive and quantitative techniques have demonstrated the ability of vasodilators to improve myocardial function and perfusion and to prevent the evolution of subclinical heart involvement to decompensated heart failure. Further research will provide a better understanding of the disease by detecting the potent contribution of coronary artery involvement, explaining differences in accelerated atherosclerosis between SSc and other autoimmune disorders, and opening directions for the development of novel treatment strategies for this life-threatening complication of SSc.
Export Options
About this article
Cite this article as:
Dimitroulas Theodoros, Giannakoulas George, Karvounis Haralambos, Garyfallos Alexandros, Settas Lucas and Kitas D. George, Micro- and Macrovascular Treatment Targets in Scleroderma Heart Disease, Current Pharmaceutical Design 2014; 20 (4) . https://dx.doi.org/10.2174/13816128113199990555
DOI https://dx.doi.org/10.2174/13816128113199990555 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
NAD in Skin: Therapeutic Approaches for Niacin
Current Pharmaceutical Design Mediterranean Diet and the Metabolic Syndrome: The Role of Protein
Current Nutrition & Food Science Cardiac Effects of Anabolic Steroids: Hypertrophy, Ischemia and Electrical Remodelling as Potential Triggers of Sudden Death
Mini-Reviews in Medicinal Chemistry Fibrinolytic Therapy in Acute Stroke
Current Cardiology Reviews Treasures Hunt in Old Mines: Terminalia chebula-Based Traditional Herbal Medicinal Products
The Natural Products Journal Recent Patents of Gene Sequences Relative to DNA Polymerases
Recent Patents on DNA & Gene Sequences Alterations in Homocysteine Metabolism Among Alcohol Dependent Patients - Clinical, Pathobiochemical and Genetic Aspects
Current Drug Abuse Reviews Antagonism by Bioactive Polyphenols Against Inflammation: A Systematic View
Inflammation & Allergy - Drug Targets (Discontinued) Application of Pharmacogenomic Approaches in the Study of Drug Response in Complex Diseases
Current Pharmacogenomics Cell and Gene Therapies in Cardiovascular Disease with Special Focus on the No Option Patient
Current Gene Therapy Potential Options to Treat Hypertriglyceridaemia
Current Drug Targets Phosphodiesterase 10 Inhibitors: New Disease Modifying Drugs for Parkinson’s Disease?
Current Medicinal Chemistry Beyond the Cardiac Myofilament: Hypertrophic Cardiomyopathy- Associated Mutations in Genes that Encode Calcium-Handling Proteins
Current Molecular Medicine Importance of Receptor-targeted Systems in the Battle Against Atherosclerosis
Current Pharmaceutical Design Transforming Mutations of Jak3 (A573V and M511I) Show Differential Sensitivity to Selective Jak3 Inhibitors
Clinical Cancer Drugs Tumor Angiogenesis: A Potential Target In Cancer Control by Phytochemicals
Current Cancer Drug Targets Bosentan in Pediatric Patients with Pulmonary Arterial Hypertension
Current Vascular Pharmacology Progression of Retinopathy in Type 1 Diabetic Women During Pregnancy
Current Diabetes Reviews The Measurement of the QT Interval
Current Cardiology Reviews Towards a Better Understanding of Cardiac and Vascular Disease in Patients with Chronic Kidney Disease
Current Cardiology Reviews