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De Moreuil C, Diot E, Agard C, Belhomme N, Lescoat A, Queyrel V, Tieulie N, Truchetet ME, Pugnet G, Berthier S, Smets P, Subran B, Lidove O, Keraen J, Mekinian A, Chatelus E, Pasquier E, Brenaut E, Rouvière B, Delplanque M, Lucier S, Courtois-Communier E, Devauchelle-Pensec V, Hachulla E. History of pre-eclampsia does not appear to be a risk factor for vascular phenotype in women with systemic sclerosis. RMD Open 2024; 10:e003626. [PMID: 38176736 PMCID: PMC10773441 DOI: 10.1136/rmdopen-2023-003626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Vascular phenotype is associated with a poor prognosis in systemic sclerosis (SSc). The identification of its risk factors could facilitate its early detection. OBJECTIVES To explore risk factors for a vascular phenotype of SSc, among them a history of pre-eclampsia. METHODS This observational multicentre case-control study enrolled adult women fulfilling European Alliance of Associations for Rheumatology 2013 diagnosis criteria for SSc and having a pregnancy history≥6 months before SSc diagnosis in 14 French hospital-based recruiting centres from July 2020 to July 2022. Cases had specific vascular complications of SSc defined as history of digital ischaemic ulcers, pulmonary arterial hypertension, specific cardiac involvement or renal crisis. Women with SSc were included during their annual follow-up visit and filled in a self-administered questionnaire about pregnancy. A case report form was completed by their physician, reporting data on medical history, physical examination, clinical investigations and current medication. The main outcome was the presence/absence of a personal history of pre-eclampsia before SSc diagnosis, according to the validated pre-eclampsia questionnaire. RESULTS 378 women were included: 129 cases with a vascular phenotype and 249 matched controls. A history of pre-eclampsia was reported in 5 (3.9%) cases and 12 (4.8%) controls and was not associated with a vascular phenotype (OR=0.96, 95% CI 0.28 to 3.34, p=0.9). Besides, Rodnan skin score and disease duration≥5 years were risk factors for vascular phenotype. CONCLUSIONS In women with SSc and a pregnancy history≥6 months before SSc, a history of pre-eclampsia is not associated with a vascular phenotype.
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Affiliation(s)
- Claire De Moreuil
- Internal Medicine, Vascular Medicine and Pneumology Department, Brest University Hospital, Brest, France
- Inserm, Univ Brest, CHRU Brest, UMR 1304, GETBO, Brest, France
| | - Elizabeth Diot
- Internal Medicine, Regional University Hospital Centre Tours, Tours, France
| | - Christian Agard
- Internal Medicine, Nantes University Hospital, Nantes, France
- Nantes University, Pole Santé, Nantes, France
| | - Nicolas Belhomme
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France
- Institut de Recherche en Santé, Environnement et Travail (IRSET), UMRS 1085, Univ Rennes, Rennes, France
| | - Alain Lescoat
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France
- Institut de Recherche en Santé, Environnement et Travail (IRSET), UMRS 1085, Univ Rennes, Rennes, France
| | - Viviane Queyrel
- Internal Medicine, Nice Cote d'Azur University, Nice, France
| | - Nathalie Tieulie
- Rheumatology, Pasteur Hospital, Nice University Hospital, Nice Sophia Antipolis University, Nice, France
| | | | - Grégory Pugnet
- INSERM UMR1027, Toulouse, France
- Internal Medicine, Toulouse University Hospital, Toulouse, France
| | | | - Perrine Smets
- Internal Medicine Department, Centre Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Benjamin Subran
- Internal Medicine Department, La Croix Saint-Simon Hospital, Paris, France
| | - Olivier Lidove
- Internal Medicine Department, La Croix Saint-Simon Hospital, Paris, France
| | - Jeremy Keraen
- Internal Medicine, Hospital Centre Cornouaille, Quimper, France
| | - Arsène Mekinian
- Internal Medicine, DHUi2B, Saint Antoine Hospital, AP HP, Université Pierre et Marie Curie, Paris, France
| | | | - Elisabeth Pasquier
- Internal Medicine, Vascular Medicine and Pneumology Department, Brest University Hospital, Brest, France
| | | | - Bénedicte Rouvière
- UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, INSERM, CHU de Brest, Brest, France
| | - Mathieu Delplanque
- Internal Medicine, Vascular Medicine and Pneumology Department, Brest University Hospital, Brest, France
| | - Sandy Lucier
- CIC 1412, INSERM, Brest University Hospital, Brest, France
| | | | | | - Eric Hachulla
- Internal Medicine Department, Centre de Référence des Maladies Auto-immunes Systémiques Rares Du Nord et Nord-Ouest de France, Lille, France
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Darabont R, Mihalcea D, Vinereanu D. Current Insights into the Significance of the Renal Resistive Index in Kidney and Cardiovascular Disease. Diagnostics (Basel) 2023; 13:diagnostics13101687. [PMID: 37238172 DOI: 10.3390/diagnostics13101687] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Initially, the renal resistive index (RRI) was investigated with the aim of improving diagnosis in kidney diseases, but this goal was not met. Recently, many papers have highlighted the prognostic significance of the RRI in chronic kidney disease: specifically, in estimating the revascularization success of renal artery stenoses or the evolution of the graft and the recipients in renal transplantation. Moreover, the RRI has become significant in the prediction of acute kidney injury in critically ill patients. Studies in renal pathology have revealed correlations of this index with parameters of systemic circulation. The theoretical and experimental premises of this connection were then reconsidered, and studies analyzing the link between RRI and arterial stiffness, central and peripheral pressure, and left ventricular flow were conducted with this purpose. Many data currently indicate that RRI is influenced more by pulse pressure and vascular compliance than by renal vascular resistance-assuming that RRI reflects the complex interplay between systemic circulation and renal microcirculation and should be considered a marker of systemic cardiovascular risk beyond its prognostic relevance for kidney disease. In this review, we overview the clinical research that reveals the implications of RRI in renal and cardiovascular disease.
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Affiliation(s)
- Roxana Darabont
- Cardiology and Cardiovascular Surgery Department, University of Medicine and Pharmacy Carol Davila, 050098 Bucharest, Romania
- Cardiology Department, University and Emergency Hospital, 050098 Bucharest, Romania
| | - Diana Mihalcea
- Cardiology and Cardiovascular Surgery Department, University of Medicine and Pharmacy Carol Davila, 050098 Bucharest, Romania
- Cardiology Department, University and Emergency Hospital, 050098 Bucharest, Romania
| | - Dragos Vinereanu
- Cardiology and Cardiovascular Surgery Department, University of Medicine and Pharmacy Carol Davila, 050098 Bucharest, Romania
- Cardiology Department, University and Emergency Hospital, 050098 Bucharest, Romania
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Chew E, Barnado A, Ikizler TA, Zent R, Frech T. Evaluation of hypertension in systemic sclerosis and systemic lupus erythematosus overlap. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2023; 8:14-19. [PMID: 36743818 PMCID: PMC9896192 DOI: 10.1177/23971983221122673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022]
Abstract
Patients with systemic sclerosis and systemic lupus erythematosus serologies present a unique challenge to the clinician when hypertension is detected in the outpatient setting. Treatment choices for non-renal crisis hypertension are different for systemic sclerosis versus systemic lupus erythematosus. Urgent laboratory studies and, in the presence of certain symptoms, imaging assessment are indicated in systemic sclerosis and systemic lupus erythematosus overlap patients with systemic hypertension. Long-term assessment of systemic hypertension may be enhanced by advances in non-contrast imaging that serve as valuable biomarkers for progressive vasculopathy. In this review, the diagnostic approach to systemic sclerosis and systemic lupus erythematosus overlap patients presenting with hypertension is discussed.
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Affiliation(s)
- Erin Chew
- Division of Rheumatology and
Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville,
TN, USA
| | - April Barnado
- Division of Rheumatology and
Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville,
TN, USA
| | - Talat Alp Ikizler
- Division of Nephrology and
Hypertension, Department of Medicine, Vanderbilt University Medical Center,
Nashville, TN, USA
- Veterans Affair Medical Center,
Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Roy Zent
- Division of Nephrology and
Hypertension, Department of Medicine, Vanderbilt University Medical Center,
Nashville, TN, USA
- Veterans Affair Medical Center,
Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Tracy Frech
- Division of Rheumatology and
Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville,
TN, USA
- Veterans Affair Medical Center,
Tennessee Valley Healthcare System, Nashville, TN, USA
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