| Cardiac (Heart) Involvement |
| This page was written by Shelley Ensz, and has not yet been medically edited. See Disclaimer. |
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| Treatments for Systemic Scleroderma Heart Involvement |
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| Overview of Treatments for Systemic Scleroderma Heart Involvement |
| Treatments for systemic scleroderma heart involvement include Bosentan (Tracleer), and calcium channel blockers such as nicardipine (Cardene) and nifedipine (Adalat, Procardia). For severe cardiac involvement of children with diffuse scleroderma and myositis, a combination therapy of corticosteroids, methotrexate, and cyclosporine may be used. |
| Beta Blockers |
| Scleroderma can cause increased heartrates and arrhythmias. Beta Blockers may be prescribed to treat these symptoms. Beta Blockers include acebutolol, atenolol, bisoprolol, metoprol, nadolol, and timolol. |
| Persons with Raynaud's should be aware that beta blockers can worsen their Raynaud's symptoms. |
| Heart Disease: Beta Blocker Therapy. Beta-blockers improve the heart's ability to relax, decrease the production of harmful substances produced by the body in response to heart failure and slow the heart rate. WebMD. |
| Bosentan, Tracleer |
| Bosentan is also known as "Tracleer". It treats many of the symptoms of systemic sclerosis. See Bosentan/Tracleer. |
| Beneficial Effects of Bosentan on Myocardial Perfusion and Function Assessed by Cardiac Magnetic Resonance Imaging and Tissue Doppler Imaging in Systemic Sclerosis. In systemic sclerosis, a short-term treatment with bosentan simultaneously improves myocardial perfusion and function, suggesting a beneficial effect on vascular dysfunction. Y. Allanore. OP0120 EULAR 2006. (Also see: Bosentan ) |
| Calcium Channel Blockers |
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| Nicardipine (Cardene) |
| Nicardipine is a calcium channel blocker type of blood pressure medication, which is also known by the brand name Cardene. MedicineNet. |
| Sustained Effects of Nicardipine on Ventricular Function in Systemic Sclerosis (SSc). These results emphasize the beneficial effect of DTCCB on cardiac involvement in SSc. Y. Allanore. FRI0310 EULAR 2004. |
| High Prevalence of Right Ventricular Systolic Dysfunction in Early Systemic Sclerosis. Reduced RVEF (right ventricular ejection fraction) appears to be a common feature in early SSc; it may be due to intrinsic myocardial involvement and is acutely improved by nicardipine. J Rheumatol. OCTOBER 2004;31:1941-5. |
| Right Ventricular Involvement and Acute Effects of Nicardipine in Systemic Sclerosis. Reduced RVEF (right ventricular ejection fraction) is a common feature in SSc, it may be due to intrinsic global myocardial involvement and is acutely improved by nicardipine. These results confirm and extend previous findings in LVEF (left ventricular ejection fraction). Yannick Allanore. ACR Conference Oct. 2003. |
| Nifedipine (Adalat, Procardia) |
| Nifedipine is a calcium channel blocker type of blood pressure medication, which is also known by the brand names of Adalat and Procardia. MedicineNet. |
| Evaluation of nifedipine efficacy on myocardial perfusion and contractility using cardiac magnetic resonance imaging and tissue Doppler echocardiography in systemic sclerosis. Fourteen days of treatment with nifedipine simultaneously improves myocardial perfusion and function, as evaluated by highly sensitive and quantitative methods. PubMed. Ann Rheum Dis. 2005 Feb 11. |
| Nifedipine Simultaneously Improves Myocardial Perfusion (Evaluated by Magnetic Resonance Imaging) and Myocardial Function (Evaluated by Tissue Doppler Echocardiography) in Systemic Sclerosis. Cardiovascular magnetic resonance imaging (MRI) and tissue Doppler echocardiography were recently shown to be more sensitive than conventional techniques for the assessment of myocardial perfusion and contractility, respectively. Yannick Allanore. FRI0291 EULAR 2004. |
| Combination: Corticosteroids, Methotrexate, Cyclosporine |
| A case of systemic sclerosis and sjogren's syndrome with cardiac tamponade due to steroid-responsive pericarditis. Pericarditis due to SSc has been reported unresponsive to steroid therapy, but several cases of steroid responsive pericarditis due to SSc or SjS have been reported. PubMed. Arerugi. 2006 Jul;55(7):827-31. (Also see: Sjogren's Syndrome) |
| Severe Cardiac Involvement in Children with Systemic Sclerosis and Myositis. Children with diffuse scleroderma and features of polymyositis are prone to develop severe cardiomyopathy. Combination therapy of corticosteroids, MTX, and cyclosporine seems to be active on muscle, skin, and lung involvement but does not impair progression of esophageal or myocardial dysfunction. The Journal of Rheumatology VOLUME 29: NO. 8 AUGUST 2002. (Also see: Diffuse Scleroderma, Juvenile Scleroderma, and Polymyositis) |
| Coronary Artery Bypass Grafting |
| Outcomes of coronary artery bypass grafting in patients with connective tissue diseases. Coronary artery bypass grafting is a safe treatment modality in patients with connective tissue diseases, with acceptable early results. Wound complications may be a problem in this patient population. Midterm results are less favorable, and reinterventions are frequently required. PubMed. Ann Thorac Surg. 2005 May;79(5):1610-4. |
| Cyclophosphamide |
| Successful autologous peripheral blood stem cell transplantation using Thiotepa in a patient with systemic sclerosis and cardiac involvement. The post-transplant course was uneventful, and the modified Rodnan skin thickness score improved from 32 to 15. The present case report demonstrates that thiotepa can be employed as a conditioning regimen for auto-PBSCT in SSc patients with cardiac involvement in order to reduce cyclophosphamide-induced cardiotoxicity. PubMed. Tohoku J Exp Med. 2006;209(1):61-67. (Also see: Stem Cell Transplants) |
| Dilatative Cardiomyopathy Associated with Scleroderma: Successful Treatment with Pulse Cyclophosphamide. The efficacy of pulse cyclophosphamide suggests that early cardiac involvement in systemic sclerosis is mainly immune-mediated. Controlled studies should evaluate the role of different immunosuppressive regimen in this setting. S.M. Weiner. AB0121 EULAR 2004. |
| Dietary Approaches for Heart Health |
| Seek medical advice for dietary approaches to heart disease. Be sure to also list all of the vitamin and herbal supplements that you are taking, or thinking about taking, with your doctor since some may interact with medications or worsen symptoms of heart disease. (Also see: Alternative Therapies ) |
| Mayo Clinic proceedings highlights research about cardiovascular benefits of omega-3 fatty acids. Two omega-3 fatty acids that have been associated with cardiovascular benefit, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are found in fish oils. EurekAlert! 03/10/08. (Also see: Diet ) |
| DASH Diet: Your Guide To Lowering Your Blood Pressure With DASH. Clinically proven to significantly reduce blood pressure! This eating plan features plenty of fruits, vegetables, whole grains, and other foods that are heart healthy and lower in salt/sodium. National Heart, Lung and Blood Institute. |
| Mediterranean diet for heart health. The Mediterranean eating style significantly reduces the risk of further heart disease in individuals who had already had a heart attack. Mayo Clinic, 06-21-06. (Also see: Alternative Therapies: Diet) |
| Pericarditis Treatments |
| Pericarditis: NSAIDS, Corticosteroids |
