Titre du document / Document title

Hormone replacement therapy may prevent the development of isolated pulmonary hypertension in patients with systemic sclerosis and limited cutaneous involvement

Auteur(s) / Author(s)

BERETTA L. ⁽¹⁾ ; CARONNI M. ⁽¹⁾ ; ORIGGI L. ⁽¹⁾ ; PONTI A. ⁽¹⁾ ; SANTANIELLO A. ⁽¹⁾ ; SCORZA R. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Unit of Immunology, IRCCS Maggiore Policlinico Hospital, University of Milan, Milan, ITALIE

Résumé / Abstract

Background: Isolated pulmonary hypertension (iPHT) is a near-fatal consequence of systemic sclerosis (SSc); in female patients, the risk of its development is increased during the post-menopausal period, when the protective effects of oestrogens on the endothelium decrease. In many animal and human models, hormone replacement therapy (HRT) and oestrogen administration proved efficacious in counteracting many mechanisms that might be implicated in the pathogenesis of iPHT. Accordingly, it has been hypothesized that HRT might help to prevent the development of iPHT. Methods: A retrospective cohort study was conducted on 61 SSc patients with the limited cutaneous form of the disease and no sign of pulmonary hypertension on echocardiogram (pulmonary artery pressure, PAP>35 mmHg) at the time of menopause. All the patients had to be stably treated with calcium-channel blockers and not to have risk factors for secondary PHT throughout the duration of the observational period. Results: Twenty patients (32.8%) received HRT for a mean of 6.7±3.7 years. None of these patients developed iPHT after a mean of 7.2±3.5 years from menopause, whereas eight out of 41 patients not receiving HRT (19.5%) developed iPHT after a similar time period (7.5±3.9 years, p=0.032). These rates were not explained by differences between the two groups with respect to autoantibodies, age, age at onset of SSc, diffusing capacity of the lung for carbon monoxide (DLCO) at menopause, or duration of therapy with calcium-channel blockers. Conclusion: HRT administration may be effective in SSc post-menopausal women, preventing the development of iPHT.

Revue / Journal Title

Scandinavian journal of rheumatology   ISSN 0300-9742   CODEN SJRHAT 

Source / Source

2006, vol. 35, n^o6, pp. 468-471 [4 page(s) (article)] (15 ref.)

Langue / Language

Anglais

Editeur / Publisher

Taylor & Francis, Colchester, ROYAUME-UNI  (1972) (Revue)

Mots-clés anglais / English Keywords

Inorganic element ; Sonography ; Immunopathology ; Connective tissue disease ; Systemic disease ; Autoimmune disease ; Respiratory disease ; Cardiovascular disease ; Rheumatology ; Lung ; Endothelium ; Scleroderma ; Human ; Pulmonary hypertension ; Replacement therapy ; Hormone ; Calcium ; Blood pressure ; Echocardiography ; Autoimmunity ; Skin disease ;

Mots-clés français / French Keywords

Elément minéral ; Exploration ultrason ; Immunopathologie ; Tissu conjonctif pathologie ; Maladie système ; Maladie autoimmune ; Appareil respiratoire pathologie ; Appareil circulatoire pathologie ; Rhumatologie ; Poumon ; Endothélium ; Sclérodermie ; Homme ; Hypertension artérielle pulmonaire ; Traitement substitutif ; Hormone ; Calcium ; Pression sanguine ; Echocardiographie ; Autoimmunité ; Peau pathologie ;

Mots-clés espagnols / Spanish Keywords

Elemento inorgánico ; Exploración ultrasonido ; Inmunopatología ; Tejido conjuntivo patología ; Enfermedad sistémica ; Enfermedad autoinmune ; Aparato respiratorio patología ; Aparato circulatorio patología ; Reumatología ; Pulmón ; Endotelio ; Esclerodermia ; Hombre ; Hipertensión arterial pulmonar ; Tratamiento sustitutivo ; Hormona ; Calcio ; Presión sanguínea ; Ecocardiografía ; Autoinmunidad ; Piel patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 4382, 35400014525035.0090