Early morphologic and functional changes of atherosclerosis in systemic sclerosis—a systematic review and meta-analysis

Aortic Stiffening Is an Extraintestinal Manifestation of Inflammatory Bowel Disease: Review of the Literature and Expert Panel Statement

“…32 –50,51 To date, at least 13 single-center cross-sectional studies 33 –45 and 2 multicenter longitudinal studies 37,50,51 suggest that aortic stiffness and reflected waves are increased in adult patients with CD and UC, even after adjustment for known CV risk factors (Table 1) and that the severity and duration of inflammation over time has a key role in the arterial stiffening process. These results have been confirmed in 4 aggregated data 32,46,47,48 and 1 individual participant data meta-analysis 49 performed in patients with IBD, which are in agreement with similar findings reported in patients with rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and periodontitis 16 –18,53 and could suggest that arterial stiffness is a vascular biomarker of chronic inflammation. 54 Further longitudinal studies are needed to confirm this hypothesis.…”

“…13 –15 Similar findings were reported in other chronic inflammatory conditions characterized by high levels of tumor necrosis factor (TNF), such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and chronic kidney disease. 16 –19 Regarding treatment, steroids are associated with an increased risk of acute arterial events in IBD. 20 In contrast, other immunosuppressive drugs may lower the risk of acute arterial events due to their anti-inflammatory actions, as increasingly recommended in rheumatoid arthritis.…”

Subclinical atherosclerosis in systemic sclerosis: Different risk profiles among patients according to clinical manifestations

“…A recent study showed an overlap between pulmonary arterial hypertension (PAH) and coronary artery disease in SSc patients, suggesting the need of a more invasive approach with right heart catheterization and coronary angiography to symptomatic patients in order to better define the type of cardiac involvement 6 . A systematic review with meta‐analysis, dealing in macrovascular involvement in SSc, showed that although different methods have been used to evaluate the presence of subclinical ATS, such as carotid ultrasound, flow mediated dilatation (FMD), nitroglycerin mediated dilatation, pulse wave velocity, augmentation index and ankle‐brachial pressure index, the greater number of authors confirms a more frequent macrovascular involvement in SSc patients with respect to controls, with an increased number of atherosclerotic plaques 7 . Therefore a complete CV risk assessment of patients is warranted 8 .…”

The “Renocentric Theory” of Renal Resistive Index: Is It Time for a Copernican Revolution?

“…Moreover, renal damage can be an expression of systemic disease activity of rheumatological diseases, which often recognize an inflammatory pathogenesis and are associated per se with widespread vascular damage and increased CV risk. In line with this, several studies demonstrated that patients with SSc had early structural and functional changes of atherosclerosis 24 as well as increased arterial stiffness 25 , even in the absence of kidney damage. Similarly, it is widely known that patients with systemic lupus erythematosus (SLE) have more extensive vascular damage than healthy subjects 26 .…”