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December 21, 2021Open Access

Flow-mediated vasodilation was significantly impaired in all systemic sclerosis patients compared to healthy controls (p<0.0001), with no significant improvement observed across different treatment regimens.

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Why the study?

Comparative analysis of flow-mediated dilation and vasoactive angiogenic and fibrogenic mediators between treatment-naive and treated systemic sclerosis patients was an unmet need.

Does vasodilator and immunosuppressive therapy improve endothelial dysfunction in patients with systemic sclerosis?

Population

SSc patients (n=24 treatment-naïve, n=10 vasodilator, n=22 vasodilator plus immunosuppressive) and 20 healthy controls

Comparison

Treatment-naïve vs vasodilator vs vasodilator plus immunosuppressive vs healthy controls

Key result

Flow-mediated vasodilation was significantly impaired in all systemic sclerosis patients compared to healthy controls (p<0.0001), with no significant improvement observed across different treatment regimens.

Authors

DBDipanjan BhattacharjeeSMSumantro MondalASAyindrila Saha

Discussion

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Member takes

Overview

Persistent endothelial dysfunction persists in SSc despite therapy; leaves open whether NO/ET-1 balance is a modifiable target.

Study Design

Type

Cross-Sectional (n=76)

Blinding

Single-blind

Multicenter

No

Structured PICO

Does vasodilator and immunosuppressive therapy improve endothelial dysfunction in patients with systemic sclerosis?

P
Population
76 participants aged 18 to 55 years, including 56 patients with systemic sclerosis and interstitial lung disease and 20 healthy controls, evaluated in a cross-sectional study.
E
Exposure
Vasodilator therapy alone or vasodilator + immunosuppressive therapy
C
Comparator
Treatment-naïve SSc patients and healthy controls
O
Outcome
Flow-mediated-vasodilation (FMD) and pathogenic mediators (NO, ET1, NO/ET1, sVCAM, sICAM, TGFβ, IL-6, VEGF, gene expressions of eNOS, iNOS, ET-1, TGFβ)surrogate

Main Result

p-value: p=<0.0001

Endothelial dysfunction persists in systemic sclerosis patients despite vasodilator and immunosuppressive therapy, potentially driven by an unaltered NO/ET1 ratio.

Limitations

  • Relatively small size of group-II
  • Cross-sectional design

Cite This Study

Bhattacharjee et al. (2021) conducted a cross-sectional in Systemic Sclerosis (n=76). Vasodilator and/or immunosuppressive therapy vs. Treatment-naive SSc patients and healthy controls was evaluated on Flow-mediated vasodilation (FMD) (p=<0.0001). Flow-mediated vasodilation was significantly impaired in all systemic sclerosis patients compared to healthy controls (p<0.0001), with no significant improvement observed across different treatment regimens.

synapsesocial.com/papers/6a93bf44ba040e773e697e86https://doi.org/10.21203/rs.3.rs-1163045/v1
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Endothelial dysfunction precedes atherosclerosis in systemic sclerosis--relevance for prevention of vascular complications2007 · 139 citations
  2. 2Endothelial dysfunction in patients with systemic sclerosis2020 · 25 citations
  3. 3Association of cytokines with endothelium dependent flow mediated vasodilation (FMD) of systemic arteries in patients with non-ischemic cardiomyopathy2007 · 4 citations
  4. 4Associations Between Left Ventricular Myocardial Involvement and Endothelial Dysfunction in Systemic Sclerosis: Noninvasive Assessment in Asymptomatic Patients2007 · 35 citations
  5. 5Up-regulation of IGF-1, RANTES and VEGF in patients with anti-centromere antibody-positive early/mild systemic sclerosis2020 · 8 citations